Holistic Service Research Articles

Cultural Immersion: More Than Maternity Care

Waminda, located on the South Coast in New South Wales, provides a holistic and culturally-safe service for Indigenous women and their families. Maternity care at Waminda is known as Minga Gudjaga, and through this service, Elders and Aunties enact thousands of years of Indigenous knowledge to ensure the cultural safety and health of Minga (mothers) and Gudjaga (babies).1 A clinical placement at Waminda for one Indigenous midwifery student proved pivotal to her growth and vision as a midwife and an Aboriginal woman.

Exploring the lived experiences of Indigenous Australians within the context of alcohol and other drugs treatment services: A scoping review.

Substance use among Indigenous peoples has been extensively researched in the Australian context. However, syntheses of existing research focused on Indigenous Australian peoples' experiences of alcohol and other drug (AOD) treatment are limited. This review sought to fill this gap. A scoping review using three databases, and the Google search engine, examined empirical and grey literature relating to Indigenous Australian peoples' lived experiences of accessing and undergoing AOD treatment. The review was not restricted to intervention type, treatment setting, substance, or individual characteristics (e.g., age or gender). The experiences of staff of Indigenous Australian service providers were excluded. Twenty-seven articles were reviewed, with most research (n=12) conducted in New South Wales. Our secondary analysis of existing research found three themes: the role of culture, the value of holistic strength-based services, and the influence of organisational components for Indigenous Australian service users in AOD treatment settings. Despite diversity of experiences, our review highlights the importance of integrating culture and facilitating holistic strength-based approaches to AOD treatment for Indigenous Australian peoples. While our review is limited by the findings and biases contained within the literature reviewed, the paucity of literature relating to the experiences of Indigenous Australian peoples within AOD treatment settings warrants further attention.

UK healthcare services for people with fibromyalgia: results from two web-based national surveys (the PACFiND study)

BackgroundThe UK’s “Getting It Right First Time” programme recommends that management of people with fibromyalgia should centre on primary care. However, it remains unclear as to how best to organise health systems to deliver services to optimise patient outcomes.AimTo profile UK healthcare services for people with fibromyalgia: provision of National Health Services (NHS) and use of non-NHS services by people with fibromyalgia.MethodsTwo online open surveys (A and B) incorporating questions about diagnosis, treatment and management of fibromyalgia and gaps in healthcare services were conducted between 11th September 2019 and 3rd February 2020. These were targeted to NHS healthcare professionals consulting with people with fibromyalgia (Survey A) and people ≥16 years diagnosed with fibromyalgia using non-NHS services to manage their condition (Survey B). Descriptive statistics were used to report quantitative data. Thematic analysis was undertaken for qualitative data.ResultsSurvey A received 1701 responses from NHS healthcare professionals across the UK. Survey B received 549 responses from people with fibromyalgia. The results show that NHS services for people with fibromyalgia are highly disparate, with few professionals reporting care pathways in their localities. Diagnosing fibromyalgia is variable among NHS healthcare professionals and education and pharmacotherapy are mainstays of NHS treatment and management. The greatest perceived unmet need in healthcare for people with fibromyalgia is a lack of available services. From the pooled qualitative data, three themes were developed: ‘a troublesome label’, ‘a heavy burden’ and ‘a low priority’. Through the concept of candidacy, these themes provide insight into limited access to healthcare for people with fibromyalgia in the UK.ConclusionThis study highlights problems across the NHS in service provision and access for people with fibromyalgia, including several issues less commonly discussed; potential bias towards people with self-diagnosed fibromyalgia, challenges facing general practitioners seeking involvement of secondary care services for people with fibromyalgia, and a lack of mental health and multidisciplinary holistic services to support those affected. The need for new models of primary and community care that offer timely diagnosis, interventions to support self-management with access to specialist services if needed, is paramount.

PENINGKATAN SKILL MAHASISWA KEBIDANAN MELALUI PELATIHAN BABY MASAGE SEBAGAI ALTERNATIF USAHA MANDIRI

Infancy is a golden period for baby growth and development so it needs special attention. Physical growth is influenced by internal and external factors. One of them is the technique of giving baby massage therapy. Monitoring and stimulating the growth and development of the baby is one of the duties of the midwife. This community service activity aims to increase insight, especially about complementary based holistic midwifery services, complementary based enterpreneurial skill and independence. The implementation of this community service activity is carried out through the following stage: 1) conducting webinars through zoom meetings in the form of education for final year students, namely exposure to basic knowledge of baby massage; 2) collaboration of midwifery students with a team of lecturers, baby massage business owners, and trainers in the implementation of baby massage; 3) individual stimulation for practice implementation of baby massage under the guidance of a team of lecturers; and 4) implementation of baby massage and direct education to mothers by trained final year students. Based on this communit service activity, it can be concluded that by increasing skills and understanding the importance of entrepreneurial spirit about baby massage as an additional insight for final year professional students.

Characterising Australian memory clinics: current practice and service needs informing national service guidelines

BackgroundMemory clinics (MCs) play a key role in accurate and timely diagnoses and treatment of dementia and mild cognitive impairment. However, within Australia, there are little data available on current practices in MCs, which hinder international comparisons for best practice, harmonisation efforts and national coordination. Here, we aimed to characterise current service profiles of Australian MCs.MethodsThe ‘Australian Dementia Network Survey of Expert Opinion on Best Practice and the Current Clinical Landscape’ was conducted between August-September 2020 as part of a larger-scale Delphi process deployed to develop national MC guidelines. In this study, we report on the subset of questions pertaining to current practice including wait-times and post-diagnostic care.ResultsResponses were received from 100 health professionals representing 60 separate clinics (45 public, 11 private, and 4 university/research clinics). The majority of participants were from clinics in metropolitan areas (79%) and in general were from high socioeconomic areas. While wait-times varied, only 28.3% of clinics were able to offer an appointment within 1-2 weeks for urgent referrals, with significantly more private clinics (58.3%) compared to public clinics (19.5%) being able to do so. Wait-times were less than 8 weeks for 34.5% of non-urgent referrals. Only 20.0 and 30.9% of clinics provided cognitive interventions or post-diagnostic support respectively, with 7.3% offering home-based reablement programs, and only 12.7% offering access to group-based education. Metropolitan clinics utilised neuropsychological assessments for a broader range of cases and were more likely to offer clinical trials and access to research opportunities.ConclusionsIn comparison to similar countries with comprehensive government-funded public healthcare systems (i.e., United Kingdom, Ireland and Canada), wait-times for Australian MCs are long, and post-diagnostic support or evidence-based strategies targeting cognition are not common practice. The timely and important results of this study highlight a need for Australian MCs to adopt a more holistic service of multidisciplinary assessment and post-diagnostic support, as well as the need for the number of Australian MCs to be increased to match the rising number of dementia cases.

Effective playing environment management improving the quality of services for daycare

The application of effective playground environment management can improve the quality of daycare (TPA) services. This study aims to describe the effective management of the playground environment in enhancing the quality of services at Daycare. The research method uses a qualitative descriptive approach. The study's data sources were one manager, five educators, and two accompanying teachers. Data collection techniques using documentation, observation, and interviews. The data analysis technique uses data triangulation techniques through data reduction, presentation, and conclusion drawing. The results and findings showed that effective playground environment management improves the quality of services implemented at was through several stages, including the planning, implementation, and evaluation stages. The planning stage determines business opportunities, meeting facilities and infrastructure standards, learning strategies, the quality of educators for education staff, and service programs. The implementation stage is done by implementing an integrated service program through holistic services. Furthermore, the evaluation stage is done by reporting the implementation and evaluation of activities in the teacher council and foundation meeting forums held in monthly meetings. This management can be used as a reference as a means of effective play management for children's play.

Family Medicine in the Digital Age: Scenarios and Recommendations

ZusammenfassungZiel Der Beitrag nimmt die Situation der hausärztlichen Medizin im digitalen Zeitalter in den Blick, um künftige Entwicklungsperspektiven zu erörtern und Handlungsmöglichkeiten aufzuzeigen. Methodik Es wurde ein strukturierter Verständigungsprozess unter Einbeziehung relevanter Stakeholder-Perspektiven durchgeführt, der sich konzeptioneller Ansätze und methodischer Elemente der Szenario-Technik bediente. Diese Technik ermöglicht auf der Grundlage einer empirisch informierten Analyse gegenwärtiger Sachlagen und Entwicklungstrends die Formulierung von Zukunftsszenarien und die Ableitung praktischer Handlungsempfehlungen. Ergebnisse In Verlängerung gegenwärtiger Tendenzen im Bereich der Ärzteschaft, der Patientinnen und Patienten, der technischen Entwicklung und des Gesundheitswesens wurden ein Best- und ein Worst-Case-Szenario zur hausärztlichen Medizin im Jahr 2050 entwickelt. Aus der Analyse und Erörterung der Szenarien ließen sich Handlungsempfehlungen für die Gegenwart ableiten. Schlussfolgerung Ausgehend von den entwickelten Szenarien formulieren wir zwölf Empfehlungen zur künftigen Stärkung einer hausärztlich-zentrierten Medizin, die eine flächendeckende, digital unterstützte holistisch-patientenorientierte Gesundheitsversorgung ermöglicht.

COST BENEFIT ANALYSIS VS COST EFFECTIVENESS ANALYSIS: A SYNOPTIC VIEW

Education presently included in professional and holistic service. Academic staff has a critical role in establishing coordination between students, parents, other educational departments, and society in order to better care for our future generations. The study's goal is to discuss cost effectiveness and cost -benefit analysis in depth, including its meaning, thought, purpose, importance and stages. For programme evaluation, the pair cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA) are helpful instruments (2015, Newcomer). In advancement nations educational development is designated more precedence. As a result, cost-benefit and cost-effectiveness analyses are becoming growingly important for educational institutions' resource production and utilization. Educational cost assessments in India will assure efficiency in the quantitative and qualitative dimensions of education.

PERCIEVED METHODS OF ENHANCING UTILIZATION OF SKILLED DELIVERY CARE SERVICES IN MUKUYUNI LOCATION, BUNGOMA COUNTY, KENYA

The study sought to establish perceived methods of enhancing utilization of skilled delivery care services in Mukuyuni location of Bungoma County in Kenya. A community-based cross-sectional study design was employed in the study. The target population for the study were women of reproductive age residing in Mukuyuni location who had delivered within a five-year time frame and willing to respond unconditionally. The researcher used systematic random sampling to select the women to be interviewed from each of the sampled villages of the study area which had a study population of 2300. 300 respondents provided the information while 2 women refused to cooperate with the researcher and 25 of the sampled women were not available during the time of study. The collected data was coded and entered into SPSS software package for processing and analysis using descriptive and inferential statistics. The data was presented using tables, charts and graphs where appropriate. 148 (49.3%) of the respondents had skilled delivery in a health facility while 152(50.7%) had unskilled delivery. Among those women who had unskilled delivery, 45 (15%) were assisted by TBAs, 94 (31.3%) by relatives and 13 (4.3%) gave birth by the roadside after intensified contractions. Suggestions that were given by respondents on how to enhance utilization of skilled delivery care services among expectant women comprised of building more health facilities increasing essential equipment in health facilities training health professionals to provide holistic and friendly services educating the community on importance of skilled delivery services giving incentives to the mothers when they deliver in the health facility providing emergency vehicles to ferry expectant women to health facilities for delivery and improvement of road infrastructure for better and faster access to health facilities. The study concluded thatthe current acceptance of utilization of skilled delivery care services in the area of study is still below average and therefore the researcher recommends that more health facilities should be constructed within the study area to reduce the distance from peoples homes to the health facility, health professionals should change their attitude and handle pregnant mothers in a friendly manner and lastly public health department should organize more community outreaches to mobilize and sensitize communities on importance of skilled attendance at delivery.

Penerapan Pencegahan Risiko Jatuh Oleh Petugas di Ruang Perawatan Stroke

Prevention The risk of falling is very important, especially for patients with stroke disorders, this must be done by caring officers in order to achieve a holistic and comprehensive service. The purpose of the study was to see the application of Fall Risk Prevention by Officers in the Stroke Treatment Room. The research design used a descriptive survey with a questionnaire instrument, with a total of 13 research samples, with the results of the study that 13 (100%) samples had implemented Fall Risk Prevention by Officers in the Stroke Treatment Room. These results indicate that the officers have been able to prevent the risk of falling. Suggestions for continuous monitoring and training for stroke care room officers regarding fall risk screening

Abstract 5278: Cancer WHIRI research: Improving the early cancer pathway for indigenous NZ peoples

Abstract Background: Māori, Indigenous peoples of New Zealand (NZ) are twice as likely to die after a diagnosis of cancer compared to non-Māori. Cancer pathways are not designed for Māori health gain and are not pandemic resilient. Māori receive delayed poorer quality treatment and those with comorbidities are undertreated [1]. Existing inequities from time of referral to cancer services through to treatment were exacerbated by the COVID-19 response in Aotearoa NZ. Coordination of care is crucial for Māori patients and whānau (family), but poorly developed along this early part of the cancer pathway. In addition, care quality is not well monitored, and the current pathway is vulnerable to changes created by pandemic conditions. Aims: This study seeks to co-design, implement and evaluate a holistic cultural and clinical cancer service that is patient and whānau centred; the Whānau Hauora Integrated Response Initiative (WHIRI) programme. This comprehensive, pandemic resilient, racism-free, hauora (wellbeing) enhancing and responsive model of care will be designed for the early part of the secondary care cancer pathway. Design and Method: The WHIRI programme includes navigation, a holistic whānau/family hauora assessment tool, proactive management by a team of clinicians and a team responsible for making systems changes. WHIRI was launched mid-pandemic (early 2020) for kaumātua (elderly Māori) with long-term conditions and ran for 3 months. During COVID we found that WHIRI had the potential to change hospital systems and improve experiences for patients and whānau. WHIRI ensures the provision of best-practice timely treatment for Māori patients and could make large gains in closing the survival gap between Māori and non-Māori in the short- to medium-term, leading to reductions in Māori cancer deaths. We plan to redesign WHIRI into a cancer programme that functions effectively in all COVID levels using qualitative Kaupapa Māori methodology. Key to this methodology is partnerships with patients, whānau, cancer clinicians, Māori navigators and The Cancer Control Agency New Zealand. We will present our methods and co-design model of cancer care. We will outline the potential to expand the model nationally with reach from primary care all the way through to palliative care. It will also provide a platform for future research to measure the impact of WHIRI on cancer and whānau care. 1. Hill S, Sarfati D, Blakely T, Robson B, Purdie G, Chen J, et al. Survival disparities in Indigenous and non-Indigenous New Zealanders with colon cancer: the role of patient comorbidity, treatment and health service Citation Format: Nina Scott, Myra Ruka, Amy R. Jones. Cancer WHIRI research: Improving the early cancer pathway for indigenous NZ peoples [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5278.

Effectiveness of International Hospice and Palliative Care Training for Health Care Professionals in Countries of the Western Pacific Region.

As hospice and palliative care is a holistic service grounded in spirituality, training in spiritual care is essential. This study aimed to describe an international workforce training program for hospice and palliative care that emphasized spiritual care and evaluate the effectiveness of the training implementation. A quasi-experimental study was conducted with 28 health care professionals from 4 countries in the Western Pacific Region, who attended the international workforce trainings on hospice and palliative care. Data were collected before and after the trainings using a self-reported survey questionnaire. The participants' palliative care knowledge, spiritual well-being, perceived stress, and compassion competency were analyzed to evaluate the training program. Whereas the participants' knowledge of hospice and palliative care ( P < .001) and compassion competency increased ( P = .004), their perceived stress decreased post training ( P = .002). This study provided an extensive description of an international workforce training program of hospice and palliative care for potential replication of the training in other regions of the world. Because training in hospice and palliative care positively influenced health care professionals' spiritual care competency, future training and studies should consider spiritual care factors, along with intellectual aspects.

The effect of servant leadership tenets and perceived impact in a community development context

The study responded to calls to extend the current understanding of servant leadership into new contexts. The selected context for investigation was the nonprofit sector in Kenya. Three objectives guided the study that sought to establish the servant leadership dimensions adopted, the impact achieved in the target communities and the effect of the dimensions on the level of impact achieved. 365 senior managers were sampled from 73 nonprofit organizations and data was collected on both dimensions of servant leadership and perceived impact in the communities served by the organizations. The study reports that ten attributes of servant leadership are relevant to the sector and are practiced to a moderate extent and this extent of adoption has accomplished a moderate level of impact in the communities served. Four tenets of servant leadership, holistic approach to work, service to others, sense of community and uprightness have a significant effect on the level of impact achieved in the communities. While a holistic approach and service to others have a negative effect, a sense of community and uprightness have a positive effect. The findings raise implications for the servant leadership theory and point to the need to complement its dimensions with the postulates of the situational leadership theory for a more appropriate application in work situations. The findings contribute toward addressing conceptual, theoretical, and empirical gaps found in the extant literature on servant leadership.

Nurses' lived experiences of caring for patients with COVID-19: a phenomenological study.

BackgroundCOVID-19 is an infectious disease caused by a novel Coronavirus which transmits from person to person throughout the world. This study aimed to explore the lived experiences of nurses’ caring for patients with COVID-2019 in the context of the healthcare system of Iran.MethodsThis is a phenomenological study with 13 participant nurses (6 men and 7 women) who were caring for COVID-19 patients in one of the university hospitals in Southeast of Iran. Qualitative data were analysed by the seven steps of Colaizzi’s method.ResultsParticipants reported around a five-month history of caring for COVID-19 patients. After analysis, 597 codes, 16 categories, four sub-themes, and one theme were extracted. “Caring from self-sacrifice to avoidance” was the main theme of the study with sub-themes of “Anxiety Chain”, “Manifestation of Humanitarian Caring”, “Ethical Challenges”, and “Challenges of Overcoming Crisis”.ConclusionsNurses explained their caring experiences with patients on a continuum from humanitarian caring and self-sacrifice to caring avoidance. Because of the multi-sources of psychological stress and ethical challenges together with this infection, healthcare managers should plan for holistic regular psychological support services, prevention of job inequalities, and do strategic planning for access to enough resources in the healthcare system.

Explanatory and Confirmatory Holistic Services Based on the Synoptic Gospels Among Children PPA Ages 14-19 Years Old Cluster Solo

A growing church is a church that prioritizes the ministry of children, because children are the next generation of the church. However, there are indications that there are still churches that do not view children's services as important and make them a priority for programs, funding, facilities and infrastructure. Service priority is more for adult services, compared to child services. This indicates that the church does not understand Holistic Ministry based on the Synoptic Gospels. Children's ministry is a very important service and requires adequate human resources support, both in terms of quantity and quality. In fact, there are indications that the Church still suffers from a lack of quality human resources, both in terms of calling and quality in carrying out child services, weak basic vocations, PPA human resources do not understand the development of the current situation so that the approach to fostering children is not appropriate. From the various problems that the researcher described above, the researcher believes that apart from these problems, the background factors of PPA children aged 14-19 years have a role in the implementation of Child Holistic Services based on the Synoptic Gospels. These backgrounds include: educational age background, economy, ethnicity, and length of time participating in PPA. For this reason, the researcher wrote a dissertation entitled: "Explanatory and Confirmatory Holistic Services based on the Synoptic Gospels among PPA Children aged 14-19 years in the Solo Cluster" to obtain empirical data from these problems and produce implications and suggestions for the development of PPA in the Solo Cluster.

Integrative Holistic Early Childhood Education (IH ECE) in Indonesia amidst the COVID 19 Pandemic

Integrative holistic services towards children in Indonesia has become a priority in Early Childhood Education (ECE). However, the COVID 19 pandemic had hindered its implementation, especially in how the teachers ought to accommodate the services of health and nutrition, parenting, and protection. The shifting school delivery from direct teaching to virtual classrooms was not anticipated. To maintain and increase the teachers’ competence in implementing integrative holistic services, around 60 teachers in Kendal Regency, Indonesia, had received six online workshops and seminars. The purpose of the research is to investigate the implementation of IH ECE by the teachers as well as to find its barriers during the pandemic. The descriptive qualitative research was employed by having three online focus groups discussions (FGD) with 17 teachers from 17 different subdistricts. The additional individual interviews, documents and literature were also conducted to strengthen the findings. The data reduction and triangulation were applied to the analysis. The research found that the teachers’ competence of ICT had improved on online teaching practices, by encouraging parents’ involvement at home. They attempted to apply STEAM learning was included in both online and limited face-to-face. For protection and health service, the teachers committed to implementing evidence-based first aid treatment for children. However, the parenting and nutrition services could not be optimum due to the physical distancing policy. It is suggested that the implementation of IH ECE amidst the pandemic requires more collaborations between the government institutions and society,

Strategi pengembangan kawasan wisata green bay beach di kabupaten Banyuwangi Jawa Timur

One of the strategies to be able to help the tourism industry players, especially marine tourism which is the main potential of the Indonesian tourism industry, is more emphasized on the ability to identify various development possibilities. Therefore, this community service activity is carried out by implementing a series of processes starting from identifying threats and opportunities from the external side as well as weaknesses and strengths on the internal side to the elaboration of community-based tourism development. The series of processes include observation and problem identification, analysis and formulation of tourism development strategies. This community service activity was carried out in the Green Bay Beach Tourism area in Banyuwangi Regency, East Java. This method of implementing community activities is focused on formulating a tourism development strategy based on a Strength, Weakness, Opportunity and Threat (SWOT) analysis. This community service activity resulted in several recommendations for tourism development in the Green Bay Beach Tourism area. The results of the strategy formulation from this activity can be continued in a more holistic community service activity scheme in order to provide insight and knowledge regarding the development of tourism area strategies.

Family attendance during critical illness episodes: Reflection on practices in Arabic and Muslim contexts.

It is common practice in healthcare systems in the Arabic region to exclude relatives when patients receive treatment for critical emergent incidents or illnesses. This exclusion is despite family members' wishes for proximity and cultural and religious values that mean being with unwell people is considered a form of worship or religious act. The marked lack of implementation of relatives' wishes in this regard is coupled with a paucity of relevant policies, guidelines, and research, despite patient populations in these countries being traditional in nature, religious, and having strong connections within their families and extended social units. The present authors reflected on this concern and advocated for increased attention to the needs and rights of critically ill patients and their families to support better quality, holistic care, especially during critical illness incidents. Healthcare professionals should consider allowing families to be present with their patients in such circumstances and appreciate the importance of family presence, despite the acknowledged challenges. The recommendations presented in this reflection may support the implementation of effective, holistic healthcare services in these countries. This reflection is also relevant to any context where care for Arabic or Muslim patients is provided.

Need Analysis for Holistic Service Learning Assessment for Malaysia Higher Education: A Review

Service-Learning (SL) demands a thorough and planned implementation process. It also involves many parties, agencies or communities, particularly in the implementation planning and evaluation process. What are the processes involved in implementing effective SL? What are the indicators and elements that need to be attended to in measuring the success of an SL implementation? What information does the practitioners need to conduct and evaluate the impact of SL? While previous studies have explained the implementation of SL, there is a vacuum in knowledge related to the holistic evaluation of SL implementation. Therefore, this article explores and reviews on the need for development of training modules that can be used by SL practitioners and collaborators from Malaysia universities, agencies, and communities to facilitate the evaluation of the effectiveness of SL activities, in line with the desire for sustainable development goal (SDG-4) for quality of education. The finding can serve as a reference or guide for all parties involved with SL, particularly lecturers in designing SL activities efficiently, and ensure the production of graduates that meet the aspirations of the National Education Philosophy. The outcomes of the study can also be useful in improving the quality of services and the research results offered by universities to the community in a meaningful and sustainable manner.

Psychospiritual in palliative care services: a literature review

Background: Palliative care provide holistic services at the physical, mental, and spiritual levels. Spiritual care is an intrinsic and essential component of palliative care that WHO has recognized. However, spiritual care is still not widely known by the community and health workers in the practice of palliative care. Methods: This literature review was written based on various books, journals, and scientific articles that related to spiritual care in palliative care. The quantitative and qualitative data were obtained, then collected and sorted into a report based on the appropriate topic. Result: Spirituality is one of the fundamental dimensions in the quality of life and maintaining culture. Thus, spirituality is an important component of palliative care. Many palliative patients understand their spiritual needs and want health professionals to help them address these needs. Various existing studies show that spiritual care provides benefits, especially in emotional needs and the search for meaning in life at the end of life. Palliative care professionals can provide spiritual care, but spiritual care is complex and requires specialized knowledge, expertise, and experience in assessing and meeting patient needs, requiring further training and education. Conclusion: Various studies have shown that palliative patients need psychospiritual care to support comfort and meaning in their lives towards the end of life. So, psychospiritual care in palliative care needs to be implemented and improved, especially in training for palliative care teams.