Background Mobile health (mHealth) provides a unique modality for improving access to and awareness of palliative care among patients, families, and caregivers from diverse backgrounds. Some mHealth palliative care apps exist, both commercially available and established by academic researchers. However, the elements of family support and family caregiving tools offered by these early apps is unknown. Objective The objective of this scoping review was to use social convoy theory to describe the inclusion and functionality of family, social relationships, and caregivers in palliative care mobile apps. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review guidelines, a systematic search of palliative care mHealth included (1) research-based mobile apps identified from academic searches published between January 1, 2010, and March 31, 2019 and (2) commercially available apps for app stores in April 2019. Two reviewers independently assessed abstracts, app titles, and descriptions against the inclusion and exclusion criteria. Abstracted data covered app name, research team or developer, palliative care element, target audience, and features for family support and caregiving functionality as defined by social convoy theory. Results Overall, 10 articles describing 9 individual research-based apps and 22 commercially available apps were identified. Commercially available apps were most commonly designed for both patients and social convoys, whereas the majority of research apps were designed for patient use only. Conclusions Results suggest there is an emerging presence of apps for patients and social convoys receiving palliative care; however, there are many needs for developers and researchers to address in the future. Although palliative care mHealth is a growing field, additional research is needed for apps that embrace a team approach to information sharing, target family- and caregiver-specific issues, promote access to palliative care, and are comprehensive of palliative needs.

This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life care with older male veterans: pain management, mental health, coping, communication, autonomy and respect, and family roles. Findings suggest that traits associated with masculinity and military culture have an influence on the end-of-life process and HPC for older male veterans. Specifically, results suggest that older male veterans may deny or minimize physical pain, decline mental health treatment, utilize maladaptive coping strategies, avoid emotional conversations, struggle to manage perceived shifts in autonomy, and experience challenges negotiating changing family roles. The authors provide clinical recommendations for providers across various disciplines to address the aforementioned concerns with older male veterans in HPC. Overall, information presented in this article may be an important contribution to the literature for building cultural competencies with older male veterans and has the potential to improve the delivery of HPC for veterans and their families.

Objectives: Sense of community (SOC) is a comprehensive psychological assessment of the relationship between person and place and relates to positive psychological outcomes in community-living adults, but has not been tested in assisted living (AL). This study describes SOC, identifies associated factors, and explores the relationship between SOC and psychological well-being with a sample of AL residents.Method: Participants included 202 residents of 21 ALs. The Brief Sense of Community Scale, a multidimensional theory-based measure, assessed total SOC (Cronbach's α = .87; M = 25.89, SD = 6.08) and dimensions of SOC (i.e. need fulfillment, group membership, influence, and emotional connection). Results:A second-order confirmatory factor analysis supported the multidimensional theoretical framework of SOC with the current sample. While bivariate correlations and multiple regressions varied by dimension, social relationships, physical health, and decisional control in the move to AL consistently yielded positive relationships with SOC factors. In the final step of a hierarchical multiple regression, total SOC significantly related to psychological well-being (F(1, 192) = 7.92, p = .005); although, its contribution was small (3%) when accounting for relevant covariates. Conclusion:Key findings suggest that the most accepted framework of SOC with communityliving adults can be applied to the AL setting, but requires additional theoretical and empirical work. Findings also provide preliminary support for the relationship between SOC and psychological well-being. The authors discuss implications for future research and clinical practice, including strategies to promote SOC for AL residents.