Cancer Genetics and Epigenetics, 2025, Vol.13, No.5, 215-223 http://medscipublisher.com/index.php/cge 220 gap will put more pressure on the staff, resulting in less than ideal care for patients and also causing them to miss the opportunity to receive comprehensive support. Even if educational programs are launched, improvements are often limited to a few aspects and long-term promotion of comprehensive and demand-designed intervention measures is still required (Figure 2) (Jeong et al., 2023). Figure 2 Satisfaction results for end-of-life care education program (Adopted from Jeong et al., 2023) The service system is often not closely connected, and there is a lack of effective coordination among hospitals, hospice care institutions and community care teams. This connection problem makes continuous care difficult to carry out, increases the burden on nurses, and also makes it hard to meet the needs of patients and their families (Terzi and Kapucu, 2022). Meanwhile, the existing model fails to effectively integrate senior practicing nurses and other members and does not clarify what each should do, which further affects patient-centered seamless palliative care (Mitchell et al., 2020; Useck-Guerrero et al., 2024). 5.3 Cultural barriers and lack of social support Insufficient cultural factors and social support are additional obstacles to achieving high-quality hospice care. In many cases, cultural taboos regarding death and end-of-life can prevent people from openly discussing the progression of the disease, formulating care plans in advance, and the patient's wishes (Lin et al., 2018; Ghezelsefli et al., 2020). Patients and their families may postpone or even avoid conversations about end-of-life care, resulting in missing the opportunity to make decisions together and develop personalized care plans, or by the time they do so, it may be too late. Gender differences and different views on end-of-life topics can complicate communication and the formulation of care plans (Seifart et al., 2020). Insufficient social support, such as limited community resources and inadequate care assistance, may cause patients and their families to feel highly stressed and lonely. This issue is more prominent in family and community care models, as the responsibility for care is usually entirely shouldered by family members, who lack external assistance. To address these cultural and social challenges, it is necessary to carry out targeted publicity and education, encourage community participation, and establish help networks, so that all patients-wherever they are-can receive care and culturally appropriate end-of-life services (Ghizalsefli et al., 2020; Mitchell et al., 2020). 6 The Improvement Directions of The Hospice Care Model 6.1 Improve policy and insurance support Improving the policy system to enable insurance to cover more items is of great significance for enhancing the quality of care for patients with advanced cancer. Good policies should promote the early implementation of palliative care, establish clear service standards, and encourage hospitals, hospice care centers and community institutions to promote effective practices. National-level policies and insurance assistance can make it easier for patients to receive support from multidisciplinary teams, reduce the care gap, and ensure that they receive appropriate and valuable care throughout the disease course (Mitchell et al., 2020).
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