Patient Dignity Research Articles

What patients and caregivers want to know when consenting to the use of digital behavioral markers

Artificial intelligence (AI)-based computational tools for deriving digital behavioral markers are increasingly able to automatically detect clinically relevant patterns in mood and behavior through algorithmic analysis of continuously and passively collected data. The integration of these technologies into clinical care is imminent, most notably in clinical psychology and psychiatry but also other disciplines (e.g., cardiology, neurology, neurosurgery, pain management). Meanwhile, ethical guidelines for implementation are lacking, as are insights into what patients and caregivers want and need to know about these technologies to ensure acceptability and informed consent. In this work, we present qualitative findings from interviews with 40 adolescent patients and their caregivers examining ethical and practical considerations for translating these technologies into clinical care. We observed seven key domains (in order of salience) in stakeholders’ informational needs: (1) clinical utility and value; (2) evidence, explainability, evaluation and contestation; (3) accuracy and trustworthiness; (4) data security, privacy, and misuse; (5) patient consent, control, and autonomy; (6) physician-patient relationship; and (7) patient safety, well-being, and dignity. Drawing from these themes, we provide a checklist of questions, as well as suggestions and key challenges, to help researchers and practitioners respond to what stakeholders want to know when integrating these technologies into clinical care and research. Our findings inform participatory approaches to co-designing treatment roadmaps for using these AI-based tools for enhanced patient engagement, acceptability and informed consent.

Exploring self-care health-related beliefs, values and attitudes with older patients.

Person-centred care is based on the notion that patients' independence and dignity is sustained during the care planning process. Negotiating person-centred care with the older person involves exploring their self-care beliefs, values and attitudes. This article discusses patient beliefs, values and attitudes in the context of self-care and suggests ways in which nurses might explore these as a collaborative enquiry. The author also describes the use of a simple reflective framework as a starting point for engaging in this exploration.

Unveiling the experiences of operation room nurses on ethical issues: a phenomenological study in Adama Hospital Medical College, Ethiopia, 2022

BackgroundOperating room nurses are critical in upholding high ethical standards in fast-paced and high-stakes environment to guarantee the safety and well-being of patients undergoing surgery to resolve life-threatening situations. A deeper understanding of ethical issues in the Operating Room helps tailor interventions and policies to address real-world challenges, enhance patient care, and assist healthcare professionals.ObjectiveThis study explored the lived experiences of Operating Room nurses regarding ethical issues in Operating Room at Adama Hospital Medical College in Adama, Ethiopia, in 2022.MethodA qualitative study using the hermeneutic phenomenological method was conducted at Adama Hospital Medical College from March 15, 2022 to April 15, 2022. Eighteen nurses were selected as participants using maximum variation purposive sampling. The data was collected through semi-structured in-depth interviews. The data was then imported into Atlas Ti 8 software to be coded and categorized. To ensure trustworthiness, the basic principles such as credibility, confirmability, dependability, and transferability were applied. Data analysis was conducted based on the Van Manen (2016) method and the results were summarized using thematic analysis.ResultsThe study revealed two main themes and ten sub-themes regarding ethical issues faced by operating room nurses. The main themes were issues related with safeguarding patient dignity and issues of Staff Professionalism and Respectful Interaction.ConclusionUpholding ethical principles and standards are critical for improving patient care and fostering positive relationships. Concepts such as Preoperative communication, ethical considerations in emergency surgeries, privacy, cultural and gender sensitivity, staff rapport, personal and professional competence, bearing responsibility, caring for patients with justice, and sterilization standards and aseptic techniques are crucial for participants. Addressing ethical concerns and ensuring compliance will enhance healthcare delivery in perioperative settings.

Better end-of-life care in surgical patients: Veterans Affairs Bereaved Family Survey – a qualitative analysis

BackgroundEnd-of-life care among surgical patients is largely understudied and far fewer studies examine such care from the family perspective. To identify potential opportunities for improvement, we explored responses of family...

Ethical issues in termination of resuscitation decision-making: an interview study with paramedics and relatives of out-of-hospital cardiac arrest non-survivors

BackgroundIn out-of-hospital cardiac arrest (OHCA), decisions to terminate resuscitation or transport the patient to hospital are ethically fraught. However, little is known about paramedics’ ethical concerns in these decision-making processes.ObjectiveTo...

Organizational silence and hidden threats to patients' dignity with schizophrenia: A qualitative study.

Maintaining patients' dignity is a key ethical requirement in healthcare and is emphasized in nursing standards. This issue is particularly significant for patients with schizophrenia because they face unique challenges such as physical and psychological difficulties, dependence on others, and social isolation, making them more vulnerable. Organizational factors can either threaten or preserve their dignity. However, there is little knowledge in this domain within the sociocultural context of Iran. This study aimed to explore the role of the healthcare organization in the dignity of patients with schizophrenia, based on the opinions of patients, healthcare personnel, and family caregivers. This qualitative study was conducted with 26 participants (16 patients, 4 family caregivers, 2 nurses, 3 psychologists, and 1 service worker) who were selected using a purposeful sampling method. The data were collected through semi-structured, in-depth face-to-face interviews until data saturation was reached. The data were analyzed via Graneheim and Lundman's method. The study protocol was approved by the Research Ethics Committee of Urmia University of Medical Sciences (IR.UMSU.REC.1401.099). Based on data analysis, participants reported the three following challenges as organizational hidden threats to patients' dignity: "Lack of facilities," "premature management," and "ineffective communication." The study findings indicated that the healthcare organization does not support the dignity of patients. Management inefficiency and lack of facilities are evident in psychiatric hospitals, and healthcare centers are not monitored based on standard criteria. Limited interactions between healthcare personnel and patients were identified as the main reasons for the neglect of patients with schizophrenia and the violation of their dignity. The results of this study can help healthcare policymakers in designing and implementing effective programs to preserve the dignity of patients with schizophrenia.

Learning From Ervin's Care: Ethics, Health Care Finance, and Human Connection.

A 70-year-old man with complex multimorbidity and intellectual disability was my patient for the last 5 years of his life. He taught me important lessons about the challenges of practicing medicine as a primary care physician. He embodied all the complexities of multimorbidity, the ways in which clinical decision making can be fraught with uncertainties and tradeoffs. He raised difficult ethical questions for his care team, questions about how to respect the dignity of patients who lack decisional capacity and who do not have surrogate decision makers. The gaps in his care revealed shortcomings of the US health care system, but his care in his final years also showed some of the bright spots in coordinated, team-based care. Most importantly, caring for this patient taught me about the rewards of the human connections that primary care physicians establish with their patients.

Nurses' perception of threats to human dignity in caring for patients with COVID-19: A qualitative study

PurposeIdentifying threats to patients' dignity is crucial for maintaining and promoting their dignity. Preserving patient dignity should be regarded as both a patient’s right and a moral obligation. This study was conducted to evaluate nurses' understanding of threats to human dignity in the care of patients with COVID-19. MethodsThis qualitative study was conducted using conventional content analysis in various clinical departments in Iran. Clinical nurses from different departments were selected through purposeful sampling. Data were collected via in-depth semi-structured interviews with 15 clinical nurses over two months in 2021 and analyzed using qualitative content analysis. ResultsDuring data analysis, two main categories and ten subcategories were identified: 1) Unethical behaviors (lack of respect for patient privacy, lack of patient involvement in decision-making procedures, ignoring the patient as an individual, aggressive behaviors, stigmatization, and failure to provide palliative and end-of-life care to patients and their families); 2) Organizational factors (inadequate financial support, lack of patient-care facilities, strict restrictions, and employing less experienced nurses in COVID wards). ConclusionThe present study showed that most participants expressed concerns about violations of patients' dignity and identified many threats to it. Based on the findings, it is suggested that other factors threatening patients' dignity be identified, the threats eliminated, and healthy treatment environments created to promote patients' dignity.

Hospital design and planning in the line of foresight of health needs

Abstract The health needs of the population are increasingly difficult to plan and predict. Technological progress, artificial intelligence, new medicines, but also ecological disasters, humanitarian crises, energy crisis and other challenges (as a Covid 19 pandemic) represent the image of our time. New design of hospitals should be able to respond to the challenges of the future: comprehensive provision of health services taking into account the patient’s needs, working conditions taking into account the hospital staff, energy efficiency and construction in accordance with high standards and reduction of CO2 emissions (green hospitals), to ensure alternative sources of electricity and water supply bearing in mind potential emergencies. The big challenge of long-term construction in which advanced technologies and new procedures cannot simply fit into a rigid building structure that is several decades old (example Serbia), so it is necessary to apply precise planning and efficient and high-quality construction in the next generation hospitals, taking into account current modern equipment and that which will appear in the future. Designing hospitals involves anticipating future healthcare challenges, technological advancements, demographic shifts, and changes in patient expectations. Hospitals emphasis on patient-centered design principles, creating environments that prioritize comfort, privacy, and dignity for patients and their families, accessibility and inclusivity, infection control and prevention, sustainability and resilience. Modern hospitals should create collaborative spaces for interdisciplinary teamwork and communication among healthcare providers, research and innovation units, but also community engagement and health promotion activities. Future hospital design requires strong multidisciplinary and cross-sectional cooperation, in which priority is given to architects dedicated to this field and their cooperation with public health and health management experts.

Ethical Dilemmas in Home Palliative Care

Abstract Background In the past two decades, there has been a noticeable shift towards home-based care, reflecting the broader trend among OECD countries to prioritize a comprehensive approach to health and well-being. This approach emphasizes preventive and proactive measures, often relying on home-based care delivered by multidisciplinary teams providing both curative and palliative care. However, the unique nature of providing care in a home environment raises ethical questions among healthcare providers, necessitating high levels of attentiveness and sensitivity from the caregiving team to address them effectively. Research Objectives This study aims to identify ethical challenges encountered by a multidisciplinary team, as perceived by managers of an organization offering home palliative services in Israel. Methods A qualitative study was conducted, involving interviews with nine key managers to explore prevalent ethical issues in delivering home-based care. Findings Thematic analysis unveiled common ethical dilemmas in providing Home Palliative Care. These dilemmas include balancing patient preferences with professional obligations, addressing the needs of both patients and their families, navigating caregiver-patient relationships, understanding patients’ cultural backgrounds, and advocating for home care as the preferred option while considering alternative treatment approaches. Conclusions Home palliative care poses ethical dilemmas for caregiving teams. It’s imperative for organizations in the home care sector to devise strategies aimed at assisting teams in navigating these challenges while upholding the autonomy and dignity of patients within their home environment. Key messages • Home-based care faces ethical challenges, requiring strategies to balance patient preferences and professional duties. • Ethical home hospice care needs strategies that respect patient autonomy and dignity.

Communion supports dignity for older adults with serious cancer: Quantitative findings from dignity therapy intervention.

Patient dignity is a key concern during end-of-life care. Dignity Therapy is a person-centered intervention that has been found to support patient dignity interviews focused on narrating patients' life stories and legacies. However, mechanisms that may affect utility of the Dignity Therapy have been little studied. In this study, we evaluate whether the extent to which patients are more communal in their interviews acts as a mechanism for increased patient dignity. We analyzed the written transcripts from Dignity Therapy interviews with 203 patients with cancer over the age of 55 receiving outpatient palliative care (M = 65.80 years; SD = 7.45 years, Range = 55-88 years; 66% women). Interviews followed core questions asking patients about their life story and legacy. We used content-coding to evaluate the level of communion narrated in each interview, and mediation analyses to determine whether communion affected dignity impact. Mediation analyses indicated that the extent to which patients narrated communion in their interview had a significant direct effect on post-test Dignity Impact. Communion partially mediated the effect of pre-test on post-test Dignity Impact. For both the life story and legacy segments of the session, narrating communion had a direct effect on post-test Dignity Impact. Narrating communion serves as a mechanism for enhancing patient dignity during Dignity Therapy. Providers may consider explicitly guiding patients to engage in, elaborate on, communal narration to enhance therapeutic utility. In addition, encouraging patients with advanced illness to positively reflect on relationships in life may improve patient dignity outcomes in palliative and end-of-life care.

End of Life Care: Compassion Beyond Cure

End-of-life care encompasses more than just medical treatment for a dying person; it is a holistic approach focused on providing comfort, love, and fulfillment during a patient’s final stages of life. This article delves into the significance of end-of-life care, emphasizing the importance of addressing physical, emotional, and spiritual needs. By prioritizing quality of life, managing pain, and offering emotional support, healthcare teams can ensure patient dignity and respect their final wishes. End-of-life care includes aspects such as hospice and palliative care, advanced directives, and the role of healthcare professionals. It discusses the importance of clear communication with patients and families regarding terminal diagnoses while also respecting cultural and individual preferences. Ethical considerations around withholding or withdrawing treatment are addressed, focusing on patient autonomy and the physician's role in difficult decisions. By embracing a holistic approach that attends to the physical, emotional, and spiritual dimensions of dying, healthcare professionals can help patients experience their final moments with dignity and peace. This approach not only benefits patients but also supports their families, ensuring that the end of life is met with respect, comfort, and serenity.

Applying Dignity Therapy to a person with Amyotrophic Lateral Sclerosis

Introduction: To understand the effects of Dignity Therapy on the physical, existential, and psychosocial symptoms of aperson with Amyotrophic Lateral Sclerosis.Method: This is a single case study exploratory, and descriptive employing a mixed method approach. In it, Dignity Therapywas applied to an individual diagnosed with Amyotrophic Lateral Sclerosis, and its effectiveness was assessed using the following scales: the Patient Dignity Inventory, the Hospital Anxiety and Depression Scale, the Spiritual Well-being Scale, and the Edmonton Symptom Assessment Scale.Results: The application of Dignity Therapy was assertive for the intended objectives, considering the reported improvement in the participant’s existential well-being, made possible by the evocation of significant memories that culminated in the creation of a legacy document for future generations. These improvements were also corroborated by lower scores on the assessment scales.Conclusion: The results of this case point to the positive effects of Dignity Therapy on physical, existential, and psychosocial symptoms, suggesting the feasibility of this intervention as an integral part of palliative care. Such an approach can help improve quality of life and give new meaning to the suffering inherent in the disease.

Keeping medical information safe and confidential: a qualitative study on perceptions of Israeli physicians

BackgroundPatients expect their information to remain confidential, and physicians have a legal and ethical obligation to keep it this way. Confidentiality is not just a legal requirement but a crucial element in establishing trust between patients and healthcare providers. Patients must feel confident that their personal and medical information is kept confidential and shared only with those who need to know. Previous studies have primarily concentrated on patients’ perceptions of medical confidentiality, data privacy, and data protection issues. However, research on the practical practices and perceptions of medical confidentiality among hospital physicians is scant, underscoring the need for a deeper understanding of this critical issue.MethodsThrough qualitative methods and as part of a large-scale study on aspects of patient dignity and responsiveness in Israel, physicians shared their views and practices on managing medical information.ResultsThe study revealed the practical challenges physicians face in upholding various aspects of data protection within hospital settings. These challenges, strategies, and deviations from data protection principles that physicians discussed are of significant practical relevance. The importance of patient consent and the practical measures for safeguarding patient information were also highlighted. While physicians acknowledged the importance of protecting patient information, they also grappled with the realities of doing so in a complex healthcare environment. In future healthcare policies, it is critical to ensure robust measures are in place to safeguard and uphold medical confidentiality. These can include specific measures to increase compliance, such as regularly monitoring compliance with confidentiality policies, producing safe and anonymous channels to voice concerns, and enforcing consequences for any breaches to ensure accountability.ConclusionsWhile protecting medical information has emerged as an important goal, it is equally crucial to strike a balance between the need to share information to advance and provide quality medical care. Physicians and policymakers must navigate this delicate balance. Additionally, organizations should strengthen compliance to enhance their monitoring and enforcement of confidentiality policies. Ineffective implementation of medical confidentiality leads to theoretical guidelines that do not translate effectively into practice.

ASSESSMENT OF KNOWLEDGE REGARDING END-OF-LIFE CARE AMONG NURSES

Background: End-of-life care is a critical component of nursing practice, aimed at providing compassionate support to patients in the final stages of life. This care focuses on ensuring patients' comfort, preserving their dignity, and addressing their emotional needs during this sensitive time. Objective: This study aims to evaluate nurses' knowledge level regarding end-of-life care practices. Methods: A cross-sectional study was conducted in a tertiary care hospital involving 108 patients who received end-of-life care over a six-month period from January to June 2023. Data collection methods included structured interviews and questionnaires directed at both the patients and their primary nurses. The data were analysed using SPSS version 25, with descriptive statistics to summarise the findings. Inferential statistics, including the chi-square test, were used to identify significant factors influencing end-of-life care quality. Results: The study involved 108 participants, primarily females (93.52%) and a minority of males (6.48%). The analysis showed that 85% of the patients experienced notable relief from physical symptoms, particularly in pain management. Moreover, 75% of the patients highlighted the importance of psychological support, while 70% emphasised the significance of spiritual care in contributing to their overall satisfaction. Including family members in care planning positively affected the emotional well-being of 65% of the patients. Key factors such as effective communication between nurses and patients (80%) and the use of individualised care plans (78%) were significantly associated with an improved quality of end-of-life care (p < 0.05). Conclusion: End-of-life care in nursing is crucial for enhancing patients' comfort, dignity, and emotional well-being. Effective pain management, psychological support, and involving family members in care planning are vital for delivering high-quality end-of-life care. Further training and resources for nurses are recommended to maintain and improve these practices.

Muerte digna: estudio mixto sobre conocimientos, actitudes y significados de estudiantes de enfermería

Introduction: death is a major concern of human beings, where it´s approach depends on multiple factors which contribute to determine its meaning and implement care towards dignifying it. Objective: to determine the knowledge, attitudes, and the meaning of dignified death for nursing students. Methodology: a 2-phase sequential mixed research: phase 1) a cross-sectional descriptive analysis including students who completed an ad hoc designed questionnaire on knowledge and attitudes; phase 2) theory based on the participation in focus groups to broaden understanding. This is a study carrying no risk according to Resolution 8430 of 1993. Results: 112 students participated in the quantitative phase, 93.75% had experienced the death of a patient during their training. They showed attitudes including interest towards death and dignity and recognized their lack of knowledge. 31 students participated in the qualitative phase where two main categories emerged: 1) constructing meanings for death, and 2) nursing care to promote patient dignity at death. Conclusion: nursing students expressed attitudes of interest and sensitivity regarding nursing care that dignifies death. However, the students noted difficulties that need to be addressed during training.

Experiences of Mental Health Nurses in Providing Care to Patients Receiving Electroconvulsive Therapy in South Korea.

In recent years, the demand for electroconvulsive therapy has been increasing in South Korea. However, there are problems due to mental health nurses' lack of understanding about electroconvulsive therapy and the absence of systematic education. This study aimed to explore mental health nurses' experiences of providing care to patients receiving electroconvulsive therapy in South Korea. We used content analysis to analyse the data collected from focus group interviews with 22 mental health nurses working in mental health hospitals. The results revealed four themes and 10 subthemes. More specifically, the results showed that mental health nurses consider themselves helpers in recovery. They pursue the physical and emotional well-being of patients receiving electroconvulsive therapy and strive to ensure that patients receive electroconvulsive therapy comfortably and safely. However, contentious issues such as concerns about patient dignity and autonomy lead to differing perceptions and attitudes towards electroconvulsive therapy and cause internal conflict during therapeutic interactions. Furthermore, insufficient education on electroconvulsive therapy leads to a lack of knowledge and difficulties in fulfilling the role of an information provider. The shortage of coping measures and support systems for issues such as extensive adverse effects and restricted medication increases the work burden immensely. These findings can serve as foundational data for the development of standardised nursing practices and systematic education for electroconvulsive therapy.

Assessing Medical Students' Understanding of Do-Not-Resuscitate (DNR) Orders.

The evolution of medical directives surrounding cardiopulmonary resuscitation (CPR) has led to the prominence of do-not-resuscitate (DNR) orders. These orders aim to respect patient autonomy and ensure dignified end-of-life care. While regulations in the United States emphasize patient choice and comprehensive discussions, Saudi Arabia's approach to DNR orders integrates Islamic principles alongside expert medical judgment. This study aimed to assess the awareness and comprehension of DNR orders among medical students at Umm Al-Qura University, Makkah, Saudi Arabia. This study employed a cross-sectional design at Umm Al-Qura University in 2023. Convenience sampling yielded a sample of 145 participants, encompassing medical students from all years (first-sixth) and medical interns. A self-administered online questionnaire assessed participants' knowledge, beliefs, and attitudes regarding DNR orders. The questionnaire specifically addressed their familiarity with DNR orders, their understanding of the Islamic perspective on DNR, and the factors influencing their attitudes toward DNR. Results: The majority of respondents (62%) were familiar with the term "DNR," but only 52% correctly defined it. Social media was the primary source of information about DNR for most respondents (56%). A significant portion of respondents (60.7%) agreed with the concept of DNR, and 54% had personal experience with the term. Patient dignity (54%), religious concerns (66.7%), and legal concerns (60.7%) were identified as important factors in DNR decisions. A majority of respondents (67%) agreed that it is acceptable to discontinue life support for DNR patients, and 49.3% believed that organ donation should be encouraged among patient families. The study found that as medical students progressed through their training (from pre-clinical to clinical years and internship), their acceptance and understanding of DNR orders generally increased. The study found that medical students possess some basic familiarity with DNR orders, but there is considerable room for advancement in their comprehension and acceptance of the topic. Addressing these knowledge gaps may lead to improved patient outcomes. The findings also underscore the need to equip future physicians with a comprehensive understanding of DNR orders, their ethical ramifications, and effective communication strategies for engaging with patients and their families.

Student radiographers’ knowledge and experience of lateral hip X-ray positioning: A survey

IntroductionThe horizontal beam lateral (HBL) position technique for X-ray imaging has been used for nearly a century; however, this can be challenging for the patient and the practitioner, as it potentially compromises patient dignity. This study explores student radiographers' knowledge and experience of lateral hip positions and their impact on diagnostic quality and patient dignity. MethodA cross-sectional mixed-method online survey of undergraduate diagnostic radiography students was completed. Likert scale assessments, rank ordering questions, and free-test qualitative responses were utilised for questions on knowledge and experience of different positioning, ease to obtain, patient dignity, diagnostic quality, and need for repeats. Data analysis included descriptive statistics and cross-tabulation non-parametric analysis against variables of age, gender and year of study. ResultsResponses were received by n = 42/158 students, a response rate of 27%. The HBL position was the most commonly repeated image (76.6%); the qualitative themes included HBL image quality issues and difficulty in the HBL positioning for elderly or frail patients, often in discomfort and pain. Analysis of student responses to perceived patient dignity in positioning identified 73.8% found the HBL undignified, and 85.7% agreed the Clements-Nakayama (CN) position would be more dignified for patients. The diagnostic image quality of the HBL position (64.2%) was compared to the CN alternative axiolateral (66.6%). Comparison of ease of obtaining the correct position for HBL (47.6%) was higher than CN position (28.6%); this could be due to the lack of experience n = 3/42 (7.1%) of this position. ConclusionOverall, student radiographers' experience and knowledge of various lateral hip positions observed in clinical practice was good. The CN position scored high for diagnostic image (66.6%) and dignity for the patient (85.7%), over the often repeated HBL position (76.6%), which scored lower for image quality (64.2%) and dignity (76.6%). Implications for practiceRadiographers should advocate for professional autonomy and explore alternative positioning techniques. Further investigation into the CN position's utilisation, image quality and radiation dose in England is recommended.

Effect of logotherapy counseling program on chronic sorrow, dignity, and meaning in life of palliative care patients: a randomized controlled trial.

Palliative care patients experience chronic sorrow with loss in dignity and meaning in life. Logotherapy is an effective way to cope with loss. This study aimed to evaluate the effect of logotherapy on chronic sorrow, dignity, and meaning in life of palliative care patients. This study was conducted with 58 adults hospitalized due to advanced cancer and assigned to either intervention or control group by simple randomization. Data were collected with descriptive information form, Palliative Performance Scale, Patient Dignity Inventory (PDI), Prolonged Grief Disorder Scale-Patient Form (PGDS-PF), and Meaning in Life Questionnaire (MIL) on admission, at the 4th and 8th weeks. The intervention group received eight sessions of logotherapy. The control group received routine care. The mean scores of PGDS-PF (p = 0.01), PDI (p = 0.01), and searched meaning subdimension of MIL (MIL-SM) (p = 0.11) decreased in the intervention group compared to controls, both at the 4th and 8th week evaluation. The mean score of the present meaning subdimension of MIL (MIL-PM) (p = 0.02) increased at the 4th week evaluation but decreased at a non-statistically significant level at the 8th week. The mean scores of PGDS-PF and PDI increased in the control group while MIL-PM and MIL-SM decreased, both at the 4th and 8th week evaluation. Logotherapy was found effective in decreasing the sorrow and dignity-related distress of palliative care patients, while increasing finding meaning in life. Logotherapy is recommended to be used by palliative care professionals to empower patients. Clinicaltrials registration number and date: NCT05129059, 19/01/2021.