There is a growing need to integrate palliative care into intensive care units and to develop appropriate knowledge translation strategies. However, multiple challenges persist in attempts to achieve this objective. In this study, we aimed to explore intensive care professionals’ perspectives on providing palliative and end-of-life care within an intensive care context. We used an interpretive description approach and interviewed 36 intensive care professionals at four hospitals in Saudi Arabia. Our findings reflect a discourse about end-of-life care driven by a do-not-resuscitate classification and challenges associated with family involvement in care goals. We provide key insights of importance for the development of strategies for the integration and knowledge translation of palliative care into intensive care contexts.

Aim To explore the association of organizational structures when integrating palliative care in intensive care units. Background Palliative care within intensive care settings has been widely recognized as an area requiring improvement when caring for patients and their families. Despite this, intensive care units continue to struggle to integrate palliative care. Methods A qualitative descriptive methodology was used. Data were collected through research interviews with 15 managers and 36 health care professionals working in intensive care. The data were analysed adopting constant comparative analysis. Results This study provides insight into a diverse range of perspectives on organizational structure in the context of facilitation and the challenges posed. Three themes were identified: Do not resuscitate policy as a gateway to palliative care, facilitating family members to enable participation and support and barriers for palliative care in intensive care unit as a result of intensive care organization. Conclusions In fostering a sustainable organizational culture and practice development in intensive care, the findings indicate the need for specific palliative care policies and implementation strategies tailored according to context. Implications for nursing management Management has a responsibility to facilitate dialogue within any multidisciplinary team regarding palliative care and, in particular, to focus on ‘do not resuscitate’ policies as a gateway into this conversation.

(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00–1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.

The objective is to examine whether one of the most used instruments for measuring attitudes towards caring for dying patients, the Frommelt Attitude Toward Care of the Dying (FATCOD-B) instrument, has the same meaning across different societal contexts, as exemplified by Swedish and Saudi Arabian intensive care professionals. A cross-sectional design used the 30-item FATCOD-B questionnaire. It was distributed to intensive care professionals from Sweden and Saudi Arabia, generating a total sample of 227 participants. Ordinal logistic regression models were used to examine the differential item functioning (DIF) for each item. Up to 12 of the 30 items were found to have significant DIF values related to: (a) Swedish and Saudi Arabian intensive care professionals, (b) Swedish and Saudi Arabian registered nurses (RNs), (c) RNs' levels of experience and (d) RNs and other intensive care professionals in Saudi Arabia. The results indicate that FATCOD should be used cautiously when comparing attitudes towards death and dying across different societal and healthcare contexts.

The Barthel Index (BI) is a standardized tool used to evaluate patients’ ability to perform daily activities. Lower scores on the index indicate greater dependency. The distribution of nursing workload is often uneven and rarely assessed using validated measures, particularly on busy days, such as those following patient admission days when care demands are higher. This study aims to quantify nursing workload in two hospital wards using the Barthel Index. This cross-sectional comparative study collected patient data through direct observation and interviews with all patients in two hospital wards in northern Greece on a busy working day. The 10-item BI was employed to determine each patient’s level of dependency. A total of 62 patients (31 females; mean age 74.5 years, range 20–94) participated in this study. Ward A had 12 nurses, while ward B had 13. On a heavy workday, the mean BI score was 45 in ward A and 20 in ward B, indicating higher patient dependency in Ward B. The BI provides a quick and objective assessment of patient dependency, which reflects nursing workload. Integrating BI assessments into routine practice could support evidence-based staffing decisions and allow for better alignment of nurse allocation with the specific needs of each ward, especially during high-demand periods.

Purpose of review: This review seeks to explain the impact of cultural and spiritual factors on end-of-life care decision-making from different countries to assist in the development of coherent responses for palliative care. Recent findings: Spiritual and cultural factors shape end-of-life decision-making in the Arab Middle East and the United Kingdom. Arab cultures emphasize dignity through faith and family, leading to collective decisions, while the United Kingdom focuses on individual autonomy. Both allow withdrawal from futile treatment to alleviate suffering, but Arab approaches are more family centric. Additionally, spirituality in Arab cultures is often collective and religious, compared to the personal and secular practices common in the United Kingdom. Summary: Western and Arab Middle East cultural beliefs influence our understanding of death, dying, and the acceptability of various care options. As people near the end of life, spiritual issues are likely to affect their values and preferences.