How to Evaluate Hospital Care in the Dying Phase-Development of a Data Extraction Tool for Retrospective Medical Record Analysis.

Background: Hospitals are the most common place of death in European countries, including Germany, where nearly half of the population dies in hospitals, mostly outside specialised palliative care wards. At the same time, quality of hospital care in the dying phase is reported as poor. Although existing (inter-)national guidelines provide outcome variables, their evaluation of implementation is lacking.

Formative evaluation of an employee-driven approach to improve care in the dying phase in hospitals.

Objectives: The hospital setting is often perceived as slow to change. While employee-driven approaches offer a promising alternative to traditional top-down methods, guidance is limited. This study provides a description and formative evaluation of an employee-driven working group (WG) approach to tailor ward-specific measures to improve care in the dying phase.

A qualitative interview study on psycho-oncologists' experiences with patient deaths in Germany.

Despite regular exposure to patient deaths, little research has explored how psycho-oncologists experience and cope with these events. This study examined the unique challenges faced by psycho-oncologists in Germany, aiming to contribute to the broader understanding of professional grief and its impact on healthcare professionals' mental health and well-being. We conducted 25 semi-structured interviews with psycho-oncologists.

Healthcare Professionals' Perceived Burden Related to Care in the Dying Phase - Results of a Cross-Sectional Explorative Study on General Wards and Intensive Care Units.

Most patients dying in hospitals die outside of specialist palliative care, making healthcare professionals of all disciplines responsible for the care of the dying. This cross-sectional study assessed how burdened healthcare professionals on non-palliative care hospital wards are when caring for dying patients. Descriptive and inferential statistics (chi and tests) were used to analyze the data.

Professional Grief in Cancer Care-A Scoping Review.

Objective: Healthcare professionals (HCPs) in cancer care often face patient deaths, yet there is a notable absence of comprehensive evidence regarding their grief. This scoping review seeks to identify key aspects of professional grief in cancer care and give an overview pertaining its' conceptualization and frequency and intensity.

Methods: The primary search covered three databases (MEDLINE, PSYNDEX, and PsycINFO).

Existential distress in advanced cancer: A cohort study.

Objective: Clinically significant existential distress may impair quality of life and communication about illness. We investigated the presence of existential distress in the form of demoralization, death anxiety, and dignity-related distress, and its co-occurrence with mental disorders in patients with advanced cancer.

Methods: We conducted structured clinical interviews and administered self-report questionnaires to assess existential distress and mental disorders.

Dying in hospital: a retrospective medical record analysis on care in the dying phase in intensive care units and general wards.

Background: Care in the dying phase is often suboptimal in hospitals outside specialized palliative care. Studies of the implementation of recommendations for care in the dying phase are rare. Medical records can provide information in this regard.

Care for the Dying: A Scoping Review of Measures for Clinical Practice With Qualitative Synthesis.

The literature describes a plethora of different measures to support healthcare professionals in the care for the dying. The aim is the identification and assessment of measures for the care in the dying phase to give healthcare professionals of all disciplines an overview on such measures in form of a self-developed toolkit. Two databases were searched systematically and all measures found ( = 7368 publications, = 308 measures) were categorized into six categories and integrated into a toolkit.

The CAREPAL-8: a short screening tool for multidimensional family caregiver burden in palliative care.

Background: Family caregivers of terminally ill and dying people do not only experience varying levels but also different dimensions of caregiver-related strain and burden. The aim of the study was to develop a short multidimensional screening tool for the detection of burden in family caregivers in palliative care.

Methods: Family caregivers of cancer patients newly admitted to specialist inpatient palliative care (N = 232) completed questionnaires on psychological burden, quality of life, social support and need fulfillment.

"Being an informal caregiver - strengthening resources": mixed methods evaluation of a psychoeducational intervention supporting informal caregivers in palliative care.

Background: Informal caregivers are key support for patients with progressive incurable diseases. However, their own needs often remain unmet. Therefore, we developed, manualised and implemented the intervention "Being an informal caregiver - strengthening resources" aiming to support and empower informal caregivers by addressing relevant information-related, physical, psychological and social needs.

Existential distress among family caregivers of patients with advanced cancer: A systematic review and meta-analysis.

Objective: Caregiving for a loved one is challenging and requires significant resources. Existential distress in family caregivers may include hopelessness, demoralization, fear of death, pre-loss grief, or a sense of not being emotionally prepared. The aim of this systematic review is to synthesize the quantitative literature on existential distress among family caregivers of patients with advanced cancer, focusing on its prevalence, association with mental disorders, as well as with sociodemographic, disease, and treatment-related factors.

Specialist palliative care until the very end of life - reports of family caregivers and the multiprofessional team.

Background: Specialist palliative care (SPC) includes care for incurably ill patients and their family caregivers at home or on a palliative care ward until the very end of life. However, in the last days of life, patients can rarely express their needs and little is known about SPC outcomes as reported by multiprofessional SPC teams and family caregivers.

Methods: Using the Palliative Care Outcome Scale (POS; Score 0-40), proxy assessments of SPC outcomes in the patient's last 3 days of life were performed by SPC teams and primary family caregivers of three home care and three inpatient services.

Association between oncologists' death anxiety and their end-of-life communication with advanced cancer patients.

Objective: Early and open communication of palliative care (PC) and end-of-life (EoL)-related issues in advanced cancer care is not only recommended by guidelines, but also preferred by the majority of patients. However, oncologists tend to avoid timely addressing these issues. We investigated the role of oncologists' personal death anxiety in the rare occurrence of PC/EoL conversations.

Screening versus multidimensional assessment of symptoms and psychosocial distress in cancer patients from the time of incurability.

Objective: Previous symptom prevalence studies show a diverse spectrum of symptoms and a large diversity in symptom intensities in patients being just diagnosed as having incurable cancer. It is unclear, how physical symptoms and psychosocial burden should be recorded in order to determine the variable need for palliative care and further support. Therefore, we compared two different strategies for detecting physical symptoms and psychosocial burden of patients with newly diagnosed incurable cancer and their effects on the further course of the disease.

Evaluation of a Routine Psychosocial Screening for Patients Receiving Inpatient Specialist Palliative Care: Feasibility and Outcomes.

This prospective one-year cohort study aimed to assess the feasibility and outcomes of a routine psychosocial screening at patients' admittance to specialist inpatient palliative care. Patients admitted to an academic palliative care ward were routinely screened for self-reported distress and psychological morbidity, psychosocial stress factors, and subjective need for help from psychosocial professions. Cognitive impairments were the most common patient barrier to screening.

Testicular germ cell tumours' clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival-a systematic review.

Purpose: Testicular germ cell tumours (GCTs) represent the most common malignancy in young adult males with two thirds of all cases presenting with clinical stage I (CSI). Active surveillance is the management modality mostly favoured by current guidelines. This systematic review assesses the treatment results in CSI patients concerning recurrence rate and overall survival in non-seminoma (NS) and pure seminoma (SE) resulting from surveillance in comparison to adjuvant strategies.

The Impact of the SARS-CoV-2 Pandemic on the Needs of Non-Infected Patients and Their Families in Palliative Care-Interviews with Those Concerned.

During humanitarian crises, such as a pandemic, healthcare systems worldwide face unknown challenges. This study aimed to explore and describe the effect of the SARS-CoV-2 pandemic on the needs of non-infected patients and family caregivers in specialist palliative care, using qualitative, semi-structured interviews. Data were analyzed using inductive content analysis, following the framework approach.

Addressing palliative care and end-of-life issues in patients with advanced cancer: a systematic review of communication interventions for physicians not specialised in palliative care.

Objective: To identify and summarise evaluated interventions aiming to improve the communication of palliative care (PC) and end-of-life (EoL) issues in physicians caring for cancer patients. Such interventions are needed with regard to the aim of an earlier communication of those issues in oncology daily practice, which is associated with a range of benefits for patients and caregivers but is often impeded by physicians' communication insecurities.

Design: Systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Looking back: Identifying supportive care and unmet needs of parents of children receiving specialist paediatric palliative care from the bereavement perspective.

Background: This study examined care needs and utilisation of psychosocial support services among parents of children who had received specialist paediatric palliative care, as well as the relationship between need fulfilment and grief. Possible differences between parents of children who died of cancer versus a non-cancer disease were explored.

Methods: This exploratory study, conducted in two specialist paediatric palliative care facilities, included parents who had lost a child within a period of 0.

Dying in hospital in Germany - optimising care in the dying phase: study protocol for a multi-centre bottom-up intervention on ward level.

Background: Hospitals are globally an important place of care for dying people and the most frequent place of death in Germany (47%), but at the same time, the least preferred one - for both patients and their relatives. Important indicators and outcome variables indexing quality of care in the dying phase are available, and various proposals to achieve corresponding quality objectives exist. However, they are not yet sufficiently adapted to the heterogeneous needs of individual hospital wards.

What are the personal last wishes of people with a life-limiting illness? Findings from a longitudinal observational study in specialist palliative care.

Background: Personal last wishes of people facing a life-limiting illness may change closer to death and may vary across different forms of specialist palliative care (SPC).

Aims: To explore the presence and common themes of last wishes over time and according to the SPC settings (inpatient vs. home-based SPC), and to identify factors associated to having a last wish.