To promote academic exchange and advance oncology nursing practice, the Academic Express column invites ISNCC members to share their latest research achievements with the global cancer nursing community. In this issue, we highlight an important study on improving supportive care for cancer patients in the last days of life. This research, led by Xiaoting Hou and Yuhan Lu from China, explores the development and implementation of a hospital-based supportive care model designed to enhance the quality of end-of-life care for cancer patients.
Why We Chose This Research Topic
This research topic was chosen in response to the urgent clinical challenges in China, where 2.57 million cancer-related deaths occurred in 2022—accounting for 26.4% of the global total—and where terminally ill patients and their families endure significant physical, psychological, and socioeconomic burdens. Driven by national policies such as the Healthy China 2030 strategy, which prioritizes comprehensive, lifelong health services, nurses—as the most frequent caregivers for cancer patients—play a pivotal role in improving end-of-life outcomes. Although growing attention to palliative care in China, the quality of care in the final days of life remains inadequate, highlighting a critical gap: the absence of systematic, evidence-based implementation programs for end-of-life supportive care.
This study adopts a problem-oriented approach to initiate a hospital-based quality improvement program, and seeks to enhance the quality of care for cancer patients in their final stages, and then to improve the quality of death of cancer patients and family satisfaction.
What We Discovered?
Between May 2023 and August 2024, the program was initiated and implemented in five hospitals located in Beijing, Nanjing, and Kunming involving 114 terminally ill cancer patients. The intervention featured 30 bundled supportive care strategies covering recognition of dying, end-of-life communication, patient-centered supportive care, family-centered supportive care, and bereavement support. By developing in-hospital practice standard and related materials, conducting stratified training, offering assistance for nurses and conducting quality supervision, these supportive care strategies have been integrated into clinical practice and implemented.
This study examined the quality of death for patients using the Good Death Inventory (GDI) and family satisfaction using the Family Satisfaction with Advanced Cancer Care-2 (FAMCARE-2) scale. Despite some cultural challenges we encountered during implementation, encouraging research results were achieved. Nurse-rated Good Death Inventory scores reached 299.81±53.70, while family-rated scores were 310.76±49.55—substantially higher than historical controls. Family satisfaction measured by FAMCARE-2 was 80.52±8.75, exceeding previous Chinese studies.
Implications for Cancer Care
The implications are multifaceted. Practically, standardized pathways integrating evidence-based strategies into routine care from recognition of dying to bereavement support can systematically address patients' physical, psychological, social and spiritual needs of both patients and families, providing clear guidance for nurses. Educationally, stratified training with ongoing specialist support ensures homogeneous implementation. Policy-wise, implementation revealed culturally sensitive approaches must balance family protective instincts with patient autonomy.
This program demonstrates that structured, hospital-based supportive care can achieve satisfactory outcomes in improving the quality of death of cancer patients and the satisfaction of their family caregivers, offering a replicable model for advancing palliative care in China and similar contexts.
Source:
Hou X, Guo R, Yu W, Yuan L, Chen G, Ma X, Zhou Y, Zhang X, Liu L, Wang Y, Lu Y. Development and implementation of a supportive care model for cancer patients in the last days of life: a hospital-based program. Asia Pac J Oncol Nurs. 2025;13:100828. doi:10.1016/j.apjon.2025.100828.
