Palliative Care

Nurse-led palliative care improves pain, fatigue, and function in advanced cancer

This systematic review and meta-analysis pooled 51 studies (n=6152) of nurse-led palliative interventions for advanced cancer. Compared with control, nurse-led care improved quality of life and functional capacity with small but consistent effect sizes. It produced moderate reductions in total pain and smaller improvements in symptom burden and fatigue. Interventions spanned symptom monitoring, structured follow-up, education, consultation, pain management, and multidisciplinary coordination. Findings support designing oncology pathways where nurses lead ongoing palliative assessment and management, especially in resource-constrained settings. 1

Systematic screening plus a community nurse increases early palliative use in colorectal cancer

This controlled before–after project implemented guideline-based early palliative care for advanced colorectal cancer at one cancer center, with another as control. The intervention combined routine palliative-needs screening, a dedicated community palliative nurse for each referral, and structured shared-care letters. Among 695 decedents, early specialist palliative care (>90 days before death) increased from 44.7% to 57.4% at the intervention site. Use fell slightly at the control site, yielding a 17.7% difference-in-differences (95% CI 3.1–32.4; p=0.018). This relatively simple model offers a reproducible template to operationalize early palliative care in disease-specific clinics. 2

Internet-delivered CBT markedly reduces distress in advanced cancer caregivers

This randomized trial assigned 200 informal caregivers of advanced cancer patients to 8-week therapist-guided internet CBT or standardized brochures. Internet CBT yielded much larger reductions in caregiver burden than brochures (mean change -11.6 vs -2.1; p=0.027; d=1.35). Anxiety and depression decreased more with CBT, while caregiver self-efficacy improved substantially, all with large effect sizes. Clinically meaningful burden reduction occurred in 67% of CBT participants versus 19% of controls (odds ratio 8.60; p=0.005). Results support therapist-guided internet CBT as a scalable option for caregiver support embedded alongside palliative oncology care. 3

Palliative interventions reduce decisional conflict for caregivers of advanced dementia

This meta-analysis synthesized eight randomized trials of palliative interventions for caregivers of people with advanced dementia. Across studies, palliative approaches reduced treatment decision-making conflict compared with usual care. Effects on caregiver satisfaction and psychological distress were less clear and require further research. The authors highlight the need for carefully designed, evidence-based materials and structured engagement strategies. Clinicians should prioritize palliative decision-support programs when guiding families through late-stage dementia choices and care transitions. 4