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Palliative care is a complex ecosystem where medicine, psychology, social justice, family history, and even art intersect. In this issue, we have gathered international studies that take palliative care far beyond conventional clinical protocols. How can we build an effective psychosocial support system for cancer patients? How do we protect the rights of those dying in prison? Why does loneliness exact as heavy a toll on the body as illness itself? How do past traumas prevent mothers from caring for their terminally ill children? And can a simple theatrical performance change an entire generation’s attitude towards the end of life? Discover the solutions, models, and approaches proposed by contemporary researchers.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
Palliative care is a complex ecosystem where medicine, psychology, social justice, family history, and even art intersect. In this issue, we have gathered international studies that take palliative care far beyond conventional clinical protocols. How can we build an effective psychosocial support system for cancer patients? How do we protect the rights of those dying in prison? Why does loneliness exact as heavy a toll on the body as illness itself? How do past traumas prevent mothers from caring for their terminally ill children? And can a simple theatrical performance change an entire generation’s attitude towards the end of life? Discover the solutions, models, and approaches proposed by contemporary researchers.
If you wish to continue any of the topics listed below through a discussion or webinar, please do not hesitate to contact us at info@paced.org.uk.
If you are a palliative care professional from Central Asia, the South Caucasus, Eastern Europe, or the Baltic States, or if you work to develop palliative care in these regions, we warmly invite you to join our community chat on Telegram. Please complete this form.
A New Model of Psychosocial Support in Oncological Palliative Care: Participatory Qualitative Study
Psychosocial support is a crucial yet structurally complex component of palliative care. Researchers H. Mikkonen, M. Hökkä, and colleagues have developed and evaluated a five-level model of such support (ranging from basic care to specialised psychotherapy). As part of a qualitative study, the authors held meetings with healthcare professionals and patients with metastatic cancer.
Participants confirmed that the stepped model can systematically organise care and improve its quality. However, they also identified key risks: staffing shortages, systemic breakdowns at the interface of care levels, and the risk of overwhelming a severely ill person with information. The authors emphasise that while this model has high potential, its implementation will require leadership from healthcare managers and adaptation to the capacity of individual institutions.
Psychosocial support is a crucial yet structurally complex component of palliative care. Researchers H. Mikkonen, M. Hökkä, and colleagues have developed and evaluated a five-level model of such support (ranging from basic care to specialised psychotherapy). As part of a qualitative study, the authors held meetings with healthcare professionals and patients with metastatic cancer.
Participants confirmed that the stepped model can systematically organise care and improve its quality. However, they also identified key risks: staffing shortages, systemic breakdowns at the interface of care levels, and the risk of overwhelming a severely ill person with information. The authors emphasise that while this model has high potential, its implementation will require leadership from healthcare managers and adaptation to the capacity of individual institutions.
Palliative Care in Prisons
This review analyses the systemic crisis within the penitentiary sector. Due to an ageing prison population and a global trend towards harsher sentencing, the mortality rate from natural causes in prisons has more than doubled over the past 17 years. Nearly a quarter of dying inmates do not receive specialised care, and prison staff are not trained in the basics of palliative care. The situation is further complicated by a conflict between security regimes and humanity: escorts frequently handcuff terminally ill patients without justification. The article highlights that keeping frail individuals in custody is both economically inefficient and inhumane, meaning the penitentiary system urgently needs fundamental reform.
This review analyses the systemic crisis within the penitentiary sector. Due to an ageing prison population and a global trend towards harsher sentencing, the mortality rate from natural causes in prisons has more than doubled over the past 17 years. Nearly a quarter of dying inmates do not receive specialised care, and prison staff are not trained in the basics of palliative care. The situation is further complicated by a conflict between security regimes and humanity: escorts frequently handcuff terminally ill patients without justification. The article highlights that keeping frail individuals in custody is both economically inefficient and inhumane, meaning the penitentiary system urgently needs fundamental reform.
Maternal Trauma in Paediatric Palliative Care: A Qualitative Study
A research group led by J. Guadarrama-Orozco has published an analysis of the personal histories of caregivers (95% of whom are women) of terminally ill children. Examining the backgrounds of 21 families, the authors found that the vast majority of mothers had been exposed to various forms of violence throughout their lives. The women's experiences were divided into four stages: adverse childhood experiences, adult stress, the onset of the child's illness, and its aftermath. Cumulative stress built up over years, and a lack of support from fathers critically depleted mothers' adaptive mechanisms, directly impairing their ability to provide quality care for their sick child. The researchers urge palliative teams to adopt a trauma-informed approach to prevent the re-traumatisation of families.
A research group led by J. Guadarrama-Orozco has published an analysis of the personal histories of caregivers (95% of whom are women) of terminally ill children. Examining the backgrounds of 21 families, the authors found that the vast majority of mothers had been exposed to various forms of violence throughout their lives. The women's experiences were divided into four stages: adverse childhood experiences, adult stress, the onset of the child's illness, and its aftermath. Cumulative stress built up over years, and a lack of support from fathers critically depleted mothers' adaptive mechanisms, directly impairing their ability to provide quality care for their sick child. The researchers urge palliative teams to adopt a trauma-informed approach to prevent the re-traumatisation of families.
A Systematic Review of Loneliness at the End of Life
This systematic review is the first to synthesise international data on the prevalence and risk factors of loneliness among terminally ill individuals. Analysing results from 15 studies involving more than 47,000 patients across Europe and North America, the researchers concluded that loneliness is an underestimated yet critical issue in palliative care. Loneliness directly diminishes quality of life in the final stages, exacerbating depression, anxiety, and even physical symptoms. Based on these findings, the researchers call on healthcare providers to look beyond purely medical support and to purposefully fund social interventions within palliative services and local communities.
This systematic review is the first to synthesise international data on the prevalence and risk factors of loneliness among terminally ill individuals. Analysing results from 15 studies involving more than 47,000 patients across Europe and North America, the researchers concluded that loneliness is an underestimated yet critical issue in palliative care. Loneliness directly diminishes quality of life in the final stages, exacerbating depression, anxiety, and even physical symptoms. Based on these findings, the researchers call on healthcare providers to look beyond purely medical support and to purposefully fund social interventions within palliative services and local communities.
‘Cicely and David’: Theatrical Art for Palliative Care
In a new qualitative study, researchers conducted an unusual educational experiment to assess how the theatrical play ‘Cicely and David’ affected university students' perceptions of palliative care. The production, performed by real hospice staff, recounts the origins of the modern palliative movement through conversations between its founder, Cicely Saunders, and a terminally ill patient.
The one-hour performance helped young people gain a deeper understanding of palliative philosophy—addressing not only physical pain but also ‘total pain’ (spiritual, social, and psychological). The art successfully translated dry medical terminology into the language of human emotion: students showed increased empathy and a personal desire to help people who are severely ill. The authors conclude that arts-based strategies are a powerful tool for dismantling the public stigma surrounding palliative care and for normalising taboo conversations about the end of life among the younger generation.
In a new qualitative study, researchers conducted an unusual educational experiment to assess how the theatrical play ‘Cicely and David’ affected university students' perceptions of palliative care. The production, performed by real hospice staff, recounts the origins of the modern palliative movement through conversations between its founder, Cicely Saunders, and a terminally ill patient.
The one-hour performance helped young people gain a deeper understanding of palliative philosophy—addressing not only physical pain but also ‘total pain’ (spiritual, social, and psychological). The art successfully translated dry medical terminology into the language of human emotion: students showed increased empathy and a personal desire to help people who are severely ill. The authors conclude that arts-based strategies are a powerful tool for dismantling the public stigma surrounding palliative care and for normalising taboo conversations about the end of life among the younger generation.
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