While many siblings of children with cancer demonstrate resilient outcomes, they also face their own unique experiences that increase their risk for acute and long-term psychosocial difficulties. It is accepted that children undergoing cancer treatment experience suffering, the alleviation of which is a main goal of palliative care, yet research has not yet explored whether siblings experience their own suffering. This work aimed to determine whether parents perceive that their child(ren) without cancer suffered throughout the illness course and how that suffering would be described.

Using literature and expert input, a survey was developed to elicit caregivers’ perceptions of suffering in their children with and without cancer and was disseminated through the American Childhood Cancer Organization. Responses regarding sibling suffering were analyzed, considering differences in accounts between bereaved caregivers and those whose child with cancer remains living.

A total of 202 parents (81 bereaved, 121 whose child with cancer remains alive) responded. Themes of sibling suffering include disconnection and/or displacement, lack of stability and certainty, emotional consequences, bearing witness, and lasting impact. One distinct theme, suffering as continued loss, emerged from bereaved parents’ responses.

Both parental groups described sibling suffering similarly despite different outcomes for their child with cancer. The idea of sibling suffering by bearing witness to what the child with cancer experienced is unique and worthy of further understanding. This work highlights the need for sibling and parent psychosocial assessment and palliative intervention throughout cancer treatment. Gaining longitudinal input from siblings and parents regarding the experience of suffering is a critical next step to develop tailored interventions.

End-of-life care in the Emergency Department (ED) can be a challenge. Defining goals of care in dementia patients may be more complex. The quality of ED medical records is relevant for better care in the last hours or days of life. In this article, we explore the identification of last days of life recognition in ED records of dementia patients.

Retrospective qualitative review of ED medical records of patients with dementia in the last 7 days of life using reflexive thematic analysis. This study was conducted at a university tertiary hospital, with a 24 h/7 days polyvalent ED. All 2021 ED medical records of dementia patients who presented to the ED within the last 7 days of their lives were included.

More than 1 in 4 patient’s medical records (n = 55, 27,4%) made no explicit reference to the identification of last days of life and only 2 medical records contained this specific designation. Most relevant issues presented under three broader themes: (I) diagnosis and prognosis concerning the last days or hours of life; (II) goals of care, medical decisions and communication about care in the last days or hours of life; and (III) comfort and needs assessment in the last days of life of patients with dementia in the ED.

There is limited identification of the last days or hours of life in ED medical records and clinical notes are of poor-quality regarding communication and shared decision making.

The diagnosis of an advanced life-threatening illness brings with it existential challenges that activate the attachment system and different attachment styles influence coping with advanced illness.

The objective of this work were (a) to analyze the influence of attachment styles of patients with advanced disease and their relatives on emotional distress and other psychological and existential aspects, and (b) to identify the most used assessment instruments to measure it, highlighting those with better psychometric properties in palliative care contexts.

Articles on attachment published from October 2005 to February 2025 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide (PRISMA) were identified by searching PubMed, PsycINFO, Google Scholar, SCOPUS, Dialnet, and the Web of Science databases.

Of 1847 studies identified, 24 were included (21 quantitative and 53 qualitative). Quality assessment revealed low risk of bias and high methodological quality. The main results indicated that a secure attachment style was associated with better coping, adaptation and adjustment strategies to the experience of illness, causing a buffering effect on suffering at the end of life. In contrast, patients with insecure attachment styles presented higher levels of emotional distress, demoralization, existential loneliness, death anxiety and showed a poorer psychological adaptation to cancer. Almost two-thirds of the studies (65.1%) used some version of Experiences in Close Relationships (ECR) scale.

The attachment theory appears to offer a valuable conceptual framework for understanding how individuals may respond to the emotional and relational demands associated with advanced illness and end-of-life care. Its contributions have been increasingly considered in literature addressing psychosocial adjustment and coping in palliative contexts

For the assessment of attachment styles in a palliative context, the most used instrument is the original ECR-M16 scale or its iderived versions.

In the cultural context of China, it holds profound significance for nursing students to engage in discussions about hospice and palliative care with their families. This study aimed to explore nursing students’ willingness to discuss hospice and palliative care with their families and the factors associated with it.

Nursing students from three schools in three Chinese provinces (n = 1,234) completed questionnaires on general information, hospice and palliative care awareness, attitude toward death, and willingness to discuss hospice and palliative care with their families. This cross-sectional analysis utilized logistic regression to investigate the predictors of participants’ willingness to discuss hospice and palliative care with their families.

The mean hospice and palliative care knowledge score was 6.68, and 19.1% were willing to discuss the topic with their families. Factors associated with nursing students’ willingness to discuss hospice and palliative care with their families included region, whether their family members considered talking about death a taboo, whether a family member was severely ill and at risk of death, their knowledge of World Hospice and Palliative Care Day, hospice and palliative care knowledge score, and death avoidance attitude. Participants with higher hospice and palliative care knowledge scores were more willing to discuss the topic with their families, while a higher death avoidance score was associated with unwillingness.

Nursing students significantly lack hospice and palliative care awareness, and their willingness to discuss the topic with their families needs improvement. Nursing schools should provide systematic and standardized hospice and palliative care education and communication skills training.

Advance care planning (ACP) is the process of helping individuals plan for their future by identifying goals of care and preferences for future care, identifying key decision makers should they be unable to make their own decisions. Hemato-oncology is a challenging specialism, one in which the transition from curative to end-of-life can be very rapid, with many patients dying in acute settings while receiving active treatment. As such, it is an area in which ACP is frequently overlooked. This qualitative study aimed to gain a better understanding of the perceived barriers and facilitators to ACP from a clinicians perspective at a large tertiary hematology center.

A questionnaire was designed and sent electronically to 39 clinical practitioners, including consultant hematologists, resident and specialty doctors, physician associates, and clinical nurse specialists. Responses were categorized following structured thematic analysis into 7 identified themes: education, communication, disease and treatment, time, patient and family support, healthcare professional support, and environment.

In total, 67% of healthcare professionals responded to the questionnaire with a median 100% completion of all questions. Staff feel unable to have ACP discussions for a variety of reasons. In analysis, the identified themes had a degree of overlap and commonality, with education identified as a theme central to all. Analysis indicated that education, and more specifically lack thereof, in the field of ACP was having a detrimental effect on staff understanding and therefore significantly impacting the ability of staff to implement ACP in hemato-oncology practice.

Further education is needed for both healthcare professionals and service users around ACP, with a deeper understanding likely to improve utilization in practice. It is proposed that earlier ACP needs to take place to ensure the opportunity is not missed in a group of diseases with prognostic uncertainty.

Duloxetine is the only agent for chemotherapy-induced peripheral neuropathy (CIPN) recommended by the American Society of Clinical Oncology. As a moderate inhibitor of cytochrome P450 isoenzyme 2D6, duloxetine is theorized to decrease the efficacy of tamoxifen, which may be used to treat estrogen receptor–positive breast cancer. A case prompted our team to review the literature to elucidate the risks and benefits of duloxetine use in patients with this cancer.

We present the case of a patient with estrogen receptor–positive breast cancer who was doing well on duloxetine for CIPN. Due to concern for the possible future need for tamoxifen, she was switched to multiple other agents, including venlafaxine, without success.

Ultimately, the patient was switched back to duloxetine due to persistent CIPN symptoms. The theoretical risk of tamoxifen interaction with duloxetine has not been demonstrated to be clinically significant in the literature.

While emerging evidence suggests venlafaxine may prove an effective alternative, duloxetine remains the agent with the strongest evidence of benefit in patients with CIPN and must remain an option in this patient population.

Dignity Therapy (DT) helps reframe and give meaning to the illness process of the terminally ill individual. This study aims to evaluate the effect of DT on meaning in life scores and, additionally, to assess how much DT can alleviate physical and emotional symptoms in cancer patients undergoing palliative care.

This was a before-and-after clinical trial, involving the recruitment of 30 patients hospitalized in a palliative care unit, who filled out the Edmonton Symptom Assessment Scale (ESAS) and the Meaning in Life Scale (MiLS) both before and after the implementation of DT.

Of the 40 patients invited to participate in the study, DT was completed by 30 (75%) participants: 22 (73%) women and 8 (27%) men. Eighteen (60%) patients died during hospitalization, while 12 (40%) were discharged. When analyzing the factors correlated with the MiLS scores, a positive association was identified between the emotional and physical domains of the ESAS, and a negative association with the total ESAS score, spiritual ESAS score, male gender, higher educational level, and a cancer diagnosis duration (>6 years).

DT contributed to clinically relevant improvement, albeit not statistically significant, observed in emotional and spiritual well-being, as well as in the meaning of life. This underscores the importance of considering DT for palliative care patients nearing death.

The purpose of this study is to examine the existing literature on end-of-life dream experiences and bucket list fulfillments among terminally ill individuals receiving hospice and/or palliative care.

A scoping review registered on Open Science Framework was conducted in accordance with the guidelines for Scoping reviews (PRISMA-ScR). An electronic search of literature was generated from EBSCO databases published until June 2024. Studies were included if they described and evaluated the effects of bucket lists and/or end-of-life wish fulfillment.

This review identified 2,234 studies, and 11 of these were included in the review. Four major themes were established using thematic content analysis: (1) impact on holistic well-being, (2) role of family in wish fulfillment, (3) cultivation of gratitude, and (4) collaborative leadership in wish fulfillment. In wish fulfillment, the results significantly pointed to the need for more intricate evaluation among patients and interventions that cover beyond the physical aspect.

Palliative and hospice care settings should work toward securing sustainable funding for structured wish-fulfillment programs to address existing accessibility gaps and further enhance the holistic nature of care in these settings. Wish-fulfillment interventions represent a powerful tool in enhancing dignity and holistic experiences for terminally ill patients. Future research efforts could strengthen programs ensuring every individual is able to achieve a sense of peace, fulfillment, and closure during their care trajectory.

Prognostic discussions are critical in the care of patients with advanced lymphoma, given the disease’s complexity, rapidly evolving treatments, and shifting potential for cure. However, previous research has paid limited attention to how these discussions unfold from both patient and clinician perspectives, particularly in the context of early conversations. The current study sought to identify key experiences that inform improvements in clinician communication and patient understanding of prognosis for patients with advanced lymphoma.

We conducted a qualitative study from July 2023 to June 2024 with 19 patients diagnosed with advanced lymphoma and 3 oncologists. Semi-structured interview transcripts were analyzed using thematic content analysis, and emergent themes were identified through consensus among a trained coding team.

Two primary themes emerged. First, patients recalled early prognostic conversations as highly focused on curative intent. Second, oncologists cited incomplete diagnostic data and concerns about overwhelming patients as reasons for limiting early discussions, often delaying deeper prognostic conversations. Clinicians reported tension between maintaining patient hope and providing comprehensive information about disease trajectory and treatment uncertainty.

Findings highlight a need for communication strategies that balance hope with realism in early prognostic discussions for patients with advanced lymphoma. Oncologists may benefit from structured, evidence-based guidance to manage information delivery over time, particularly in the face of diagnostic ambiguity. Future research should prioritize inclusive sampling and explore timing and content of ongoing prognostic discussions to better support informed decision-making and goal-concordant care.