{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:40:36Z","timestamp":1789018836381,"version":"build-2803163510"},"reference-count":44,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"unspecified","delay-in-days":344,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1478951525101120_sec1a\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to systematically identify patient-reported end-of-life (EOL) care needs of patients with incurable illnesses, and advocate for a person-centered approach to care in Bangladesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101120_sec2b\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study was conducted in four tertiary care hospitals across Bangladesh and included 301 adult patients who had at least one of the following serious and complex incurable conditions: stage III or IV cancer, congestive heart failure (NYHA Class IV), end-stage liver disease, chronic renal failure requiring hemodialysis, stroke, oxygen-dependent pulmonary disease, or any type of dementia. Specific domains of EOL care needs were identified in relation to patients\u2019 functional status using multinomial logistic regression. Differences in EOL care needs across socio-demographic and symptom profiles were analyzed using independent\n                      <jats:italic>t<\/jats:italic>\n                      -tests and one-way ANOVA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101120_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All patients had a Needs Near the End-of-Life Care Screening (NEST-13) score \u226530, indicating a high level of EOL care need. High levels of unmet needs were reported in domains such as doctor\u2013patient communication (89.4%), goals of care (78.1%), spiritual needs (77.4%), and caregiving (66.4%). Patients with longer disease duration (&gt;12 months) and higher symptom burden had significantly higher NEST scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Functional status strongly influenced care needs. Multinomial regression confirmed physical care needs (OR\u00a0=\u00a010.59), caregiving (OR\u00a0=\u00a03.40), and spiritual needs (OR\u00a0=\u00a02.81) were most strongly associated with terminal status (PPS\u00a0\u2264\u00a020%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1478951525101120_sec4d\">\n                    <jats:title>Significance of the result<\/jats:title>\n                    <jats:p>This study reveals an overwhelming burden of unmet EOL care needs among patients with incurable diseases in Bangladesh. The findings emphasize the urgent necessity for holistic, culturally sensitive, and person-centered care, alongside the integration of palliative care into mainstream healthcare services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1478951525101120","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T10:27:53Z","timestamp":1765448873000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of end-of-life care needs among patients with incurable diseases in Bangladesh: A multicenter study"],"prefix":"10.1017","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4977-6136","authenticated-orcid":false,"given":"Jheelam","family":"Biswas","sequence":"first","affiliation":[{"name":"National Institute of Cancer Research and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mastura","family":"Kashmeeri","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. Shamsudduha","family":"Tauhid","sequence":"additional","affiliation":[{"name":"Sher-E-Bangla Medical College and Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nahid","family":"Afsar","sequence":"additional","affiliation":[{"name":"250-Bedded General Hospital, Thakurgaon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafsana","family":"Rouf","sequence":"additional","affiliation":[{"name":"Khulna Medical College Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabikun Naher","family":"Urmy","sequence":"additional","affiliation":[{"name":"Gopalganj Medical College Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salma Ahsan","family":"Khanam","sequence":"additional","affiliation":[{"name":"Kurmitola General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shima Rani","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Palliative Care Society of Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashid","family":"Islam","sequence":"additional","affiliation":[{"name":"Bangladesh Cancer Society and Welfare Home"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"S1478951525101120_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256927"},{"key":"S1478951525101120_ref19","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2016-0277"},{"key":"S1478951525101120_ref23","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951523001165"},{"key":"S1478951525101120_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhip.2022.100271"},{"key":"S1478951525101120_ref34","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32513-8"},{"key":"S1478951525101120_ref1","first-page":"20503121231191554","article-title":"Validation of Bengali version of Edmonton symptom assessment scale-revised (ESAS-r Bengali): A multidimensional symptom assessment tool for patients with advanced incurable diseases receiving palliative care","volume":"22","author":"Afsar","year":"2023","journal-title":"SAGE Open Medicine"},{"key":"S1478951525101120_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951524002074"},{"key":"S1478951525101120_ref6","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp11X549018"},{"key":"S1478951525101120_ref27","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2005.8.503"},{"key":"S1478951525101120_ref37","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S434509"},{"key":"S1478951525101120_ref39","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-024-01489-1"},{"key":"S1478951525101120_ref18","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00126107"},{"key":"S1478951525101120_ref3","doi-asserted-by":"publisher","DOI":"10.5152\/FNJN.2023.23032"},{"key":"S1478951525101120_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-023-01275-5"},{"key":"S1478951525101120_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2010.00907.x"},{"key":"S1478951525101120_ref11","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2024-004997"},{"key":"S1478951525101120_ref7","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200012150-00014"},{"key":"S1478951525101120_ref32","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2017.0065"},{"key":"S1478951525101120_ref36","first-page":"1335","volume-title":"Oxford Textbook of Palliative Medicine","author":"Li","year":"2021"},{"key":"S1478951525101120_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/NJH.0000000000000170"},{"key":"S1478951525101120_ref40","doi-asserted-by":"publisher","DOI":"10.1353\/hcr.2005.0096"},{"key":"S1478951525101120_ref41","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2009.0170"},{"key":"S1478951525101120_ref43","first-page":"266","volume-title":"Introducing Palliative Care","author":"Twycross","year":"2021"},{"key":"S1478951525101120_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2010.05.002"},{"key":"S1478951525101120_ref28","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050626"},{"key":"S1478951525101120_ref35","doi-asserted-by":"publisher","DOI":"10.1097\/jnr.0000000000000277"},{"key":"S1478951525101120_ref44","unstructured":"WHO. 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0), which permits non-commercial re-use, distribution, and reproduction in any medium, provided that no alterations are made and the original article is properly cited. The written permission of Cambridge University Press or the rights holder(s) must be obtained prior to any commercial use and\/or adaptation of the article.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e213"}}