Online First

Abstract
Objective: To analyze the knowledge, application, and barriers faced by healthcare professionals regarding Advance Care Planning, as well as to propose a formative and operational intervention model that facilitates its effective implementation across different levels of the healthcare system.
Methods: A search of articles published in the databases PubMed, Dialnet, Google Scholar, Scielo, and Scopus, from the last 10 years was carried out, the search began in November 2023 and ended in January 2024.
Results: 102911 studies were identified, of which 27 were selected according to the inclusion criteria. The findings were analyzed by grouping them into four: Knowledge of healthcare personnel about advance decision planning; Application of advanced decision planning; Barriers in its implementation; and Quality at the end of life. The review evidenced that, although there is an ongoing effort to expand knowledge about advanced decision planning, there are still persistent formative gaps that generate uncertainty in healthcare professionals and hinder its application in clinical practice.
Conclusions: Despite the continuous effort of health professionals to be trained in advance decision planning within palliative care, their knowledge remains limited. Its implementation facilitates decision making, reducing anguish in patients, family members and healthcare team, as well as avoiding unnecessary procedures. It is crucial to strengthen training in this field to improve the quality of end-of-life care.

Introduction: The Palliative sedation at home is a management alternative in the control of refractory symptoms of people in end-of-life, reducing the suffering of the sick person and his/her family. Materials and methods: It’s a quantitative, descriptive, number of cases study, based on the review of clinical records of patients who received palliative sedation treatment as part of end-of-life care in a Palliative care home program in Bucaramanga, Colombia. It’s shown absolute and relative frequencies for qualitative variables, and measures of central tendency for quantitative variables. Results: most patients presented dyspnea as only refractory symptom at the end-of-life, a combination of morphine and midazolam was used in most cases, and the average duration from the onset of sedation to death was 1.72 days. Discussion: Unlike other studies, the proportion of patients with oncological and non-oncological diseases was equivalent, the dyspnea continues to be the main at end-of-life, patient death occurred in less than 48 hours, which ratifies the indication for palliative sedation.

Patients with palliative needs can be more prompt to medication errors, due to several factors such as the presence of polypharmacy, complex drug regimens, advanced age, and the presence of associated comorbidities. The objective of the present study is to analyze the factors related to the presence of medication errors with opioids, in patients with advanced chronic disease and palliative needs attended by home palliative care teams in a region. The presence of medication error was associated with a lower level of patient education, p<0.001, and with a lower number of days of follow-up by the home palliative care teams, p<0.001. A multivariate analysis was performed where all the variables associated with medication error were introduced with p<0.20, resulting in a model, p<0.001, -2LL 435.579 and Nagelkerke R squared 0.231. With this, an explanatory model was obtained in which, if the patient had the last treatment written by the professional, OR (95% CI) 0.300 [0.126-0.711], p<0.006, he was protected by 70% of a medication error to occur, and having adherence to treatment, OR (95% CI) 0.132 [0.073-0.241], p<0.000, was 87% protective against a medication error occurring. On the contrary, patients who were illiterate or only knew how to read and write, OR (95% CI) 2.090 [1.241-3.520], p<0.006, had twice the risk of a medication error occurring than if they had primary education , secondary or university.

Objective: Identify to what extent spiritual needs are recorded in patients when referred to a Palliative Care Unit.
Material and Methods: Data from 1,159 palliative care patients were collected, primarily concerning the spiritual and psychosocial needs reported by professionals in the referral protocol. Along with descriptive analyses, the relationship between spiritual and psychosocial needs was evaluated using the Chi-Square statistic and Fisher's Exact Test.
Results: The sample includes a similar percentage of men and women, mostly over 66 years old with a history of cancer. A low recording of spiritual needs was observed, with existential distress being the most prominent among them. Approximately half of the participants had some form of psychoemotional need. The relationship between both types of needs was found to be statistically significant.
Discussion: Despite the recognized prevalence and importance of patients' spiritual needs, the study shows a deficiency in the recording of these needs during palliative care admissions. The findings suggest the need to include spirituality in the training curricula of professionals, as well as to develop standardized tools that facilitate a comprehensive and early assessment of these needs.

Managing difficult-to-control pain in patients with cervical cancer represents a major challenge for the palliative care team, combined with limited social factors and suffering; having a clinical tool such as plasticine human figures favors expression and an appropriate therapeutic approach.

Patients with Advanced Congestive Heart Failure (ACHF) depending on their complexity may be eligible for specialized Palliative Care (PC) treatment. The profile of cardiology patients admitted to a Medium Stay Palliative Care Unit (MSPCU) is described in comparison to patients with other non-oncological and oncological pathologies.