New Advances in Palliative Care

Dear Colleagues,

Today, palliative care is seen as an essential part of healthcare. According to the the World Health Organisation’s (WHO) definition, “Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” Nevertheless, it is often associated with cancer and oncology patients, and both professionals and the public are lacking awareness that other patient groups with chronic life-limiting diseases, different ethnicities and diverse backgrounds may benefit from the provision of palliative care by community health services and/or specialized palliative care teams. New approaches to include all patients in need are paramount.

During the COVID-19 pandemic, palliative care provision was hampered, and new ways of providing palliative care during a pandemic had to be established. One method of communication during the pandemic was telemedicine and tele-palliative care.

There are many open questions concerning the inclusion of other groups than cancer patients in palliative care. Other questions are how to provide palliative care in pandemic times and along with curative intended therapy in intensive care and emergency medicine.

The goal of the Special Issue, “New Advances in Palliative Care”, is to highlight recent advances and challenges in palliative care that are connected to the inclusion of different patient groups in palliative care, palliative care in pandemic times, tele-palliative care and the use of modern technology in the field of palliative care. 

This Special Issue will be of interest for researchers and clinicians from various fields and for policymakers, officials and politicians who are responsible for public health decisions and policies for the future. Thus, manuscripts on advances in palliative care from a broad range of disciplines and on a wide range of topics are welcome.

We look forward to receiving your contributions

Dr. Georg Bollig
Prof. Dr. Erika Zelko
Guest Editors

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• palliative care
• advances
• home death
• hospital death
• tele-palliative care
• diverse patient groups

Title: The last year of life in prospect: health-related quality of life and views of patients on healthcare delivery: Results of a Phase II intervention study
Authors: Frey Jana Sophie1, Kasdorf Alina 1, Raymond Voltz 1,2,3, Julia Strupp1, on behalf of the CoRe‑Net
Affiliation: 1Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany. 2Center for Health Services Research, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany. 3Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
Abstract: Background: The last year of life is a sensitive time for patients and their care partners, as it affects almost all health and social care structures. General hospital units play a central role here, as they are the main point of contact for transitions in the last year of life. However, relatives of patients who have died are the least satisfied with hospital care, and there is a lack of identification of these patients and appropriate referral to palliative care. Patients who do not have cancer are particularly disadvantaged in terms of care and are often delayed or not included in palliative care structures. To promote patient-centered care for patients with and without cancer at the end of life, including palliative care, the study aims to implement a two-sided (healthcare professionals and patients) minimally invasive intervention for general hospital wards. Methods: A prospective intervention study with two arms and a pre-post design with critically ill inpatients and outpatients of a university hospital with and without cancer. Using a multiple time point survey over the course of a year, the appropriateness of healthcare in the last year of life was measured from the patient's perspective using PROMS. Results Of the 56 patients, 32 were control participants and 24 were intervention participants. The median age at baseline was 65.50 and 62 years, respectively. During the course of the study, it became apparent that patients were no longer physically and/or mentally able to participate in the study due to the often-advanced stage of the disease, especially in the non-cancer patients. Conclusion: There were many challenges in implementing the intervention and recruiting patients. The study showed that the patients enrolled were often already very ill. The need for palliative care should be identified at an early stage, e.g. by the responsible outpatient specialist, so that patients could receive palliative care as early as possible if they wished.

Title: Conceptualizing childhood grief: Young people as active agents in a transactional process
Authors: Ceilidh Eaton Russell, PhD, CCLS *Co-lead author; Meg Chin, MSW, PhD candidate *Co-lead author; Georg Bollig, MD, MAS, PhD, DEAA; Cheryl-Anne Cait, MSW, RSW, PhD; Franco A. Carnevale, PhD (Psych), PhD (Phil); Jody Chrastek, RN, CHPN, DNP, FPCN; Bianca Lavorgna, BBSci, GradCertBerCouns, MCouns&PsychTh, CBP; Catriona Macpherson EdD Stacy S. Remke, MSW, LICSW, APHSW-C; Lies Scaut, BSW, MFT; Jane E. Skeen, MNZM, BSc, MBChB, Dip Obst, FIWGddb; Regina Szylit, RN, MsN, PhD; Camara van Breemen, MN, NP(F); Ronit Shalev, PhD
Affiliation: 1. Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada 2. Very Special Kids - Children’s Hospice & Family Support, Melbourne, VIC Australia The University of Melbourne, Department of Social Work, Melbourne School of Health Sciences, Melbourne, VIC, Australia 3. Department of Anesthesiology, Intensive Care, Palliative Medicine and Pain Therapy, Helios Klinikum Schleswig, Germany University of Cologne, Faculty of Medicine and University Hospital, Department of Palliative Medicine, Germany 4. Faculty of Social Work, Wilfrid Laurier University, Kitchener, Ontario, Canada 5. Ingram School of Nursing, Department of Pediatrics, Biomedical Ethics Unit, Counseling Psychology, McGill University, Montreal, Canada 6. Children’s of Minnesota Hospitals and Clinics , 7. Monash University, Faculty of Education, Department of Counselling, VIC, Australia NHS Fife, Scotland 8. School of Social Work, University of Minnesota, St Paul, MN, USA 9. PXL University, Department of Healthcare, Belgium Portland Institute for Loss and Transition, USA De Weg Wijzer, Expertisecentre for Loss and Trauma, Belgium 10. Independent Scholar 11. Maternal-Infant and Psychiatric Nursing Department of the University of São Paulo School of Nursing 12. Canuck Place Children’s Hospice, Vancouver, BC Canada University of British Columbia, Department of Palliative Medicine, Canada 13. Department of Educational Counselling, Max Stern Academic College of Emek Yezreel,
Abstract: Childhood bereavement affects children and young people’s mental health, physical, psychosocial and relational development, academic and career trajectories. With more than 60 million annual deaths worldwide, many millions of children grieved these deaths and innumerable non-death losses. A significant body of research has examined impacts and outcomes of childhood bereavement and supportive interventions, highlighting a myriad of factors that influence each child's unique and complex experience of grief, necessitating a person-centred approach to support provision. The theoretical framework underpinning these supports includes a combination of well-established grief theories derived and studied primarily in adult populations, as well as foundational, stage-based developmental theories that are critically limited, characterize young people as immature and incapable, and development as “normative” and universal. In contrast, transactional models recognize development as a dynamic bidirectional interplay in which children, viewed as active agents, interact with their social contexts. Therefore, in this article we propose that children and young people are active agents in a transactional process through which childhood grief is constructed and evolves over time. This conceptualization of grief invites: a holistic consideration of the contextual, relational experiences of grief, an examination of how bidirectional interactions contribute to similarities and variations in developmental trajectories, and recognition of opportunities for professionals, family and community members to support grieving children and young people with compassionate curiosity and cultural humility, and to nurture grief-literate communities.