This thematic grid, which has been updated with the most recent citations [11,14,19,30,35-64], was composed of 4 main “areas” #Buparlisib nmr randurls[1|1|,|CHEM1|]# (i.e. A, B, C and D) and of 12 “sub-areas” (i.e. A1, A2, etc.) (see table ​table11). Table 1 Thematic grid The content analysis of the documents was carried out with a view to finding out in the texts the various areas and sub-areas of the framework. Results Overall, 34 organizations were identified, i.e. 7 international organizations, and 27 organizations operating on the national level in four Inhibitors,research,lifescience,medical different countries (Australia, Canada, UK and United States). Fifty-six documents were

selected and analysed. Additional file 1 provides a Inhibitors,research,lifescience,medical list of the documents, including the reference to the name and the level of representativeness (international, or national) of the organization which produced the document, and the code assigned to the document in the course of texts analysis. Moreover, the table indicates the various types of documents selected

for this study: most of them (38) are position statements. Additional file 2 shows all the relevant quotations from the documents analysed. The attachment consists Inhibitors,research,lifescience,medical of several tables sorting quotations by “areas” and “sub-areas”, in order to illustrate the specific quotes referring to the elements of the framework. The presence and the specific meaning of sub-areas in the documents are reported in the following. A – SYMPTOMS A1 – Symptom control There is a large convergence of most documents on symptom control, in particular on pain. Pain treatment is as important for doctors Inhibitors,research,lifescience,medical and for nurses. The importance of an impeccable early symptom assessment before treating is highlighted. Inhibitors,research,lifescience,medical There is a different emphasis on the expected results of symptom control in the documents: some of them refer to “freedom” from pain (e.g. WHO I, EAPC II), whereas others are focussed on “managing” (e.g. WHO II, USA ACS, USA AMA) or “alleviating”, “easing” and “mitigating” them (e.g. ICN, ESMO, CANADA CHPCA

I, USA NHPCO I). Physical pain is mostly considered as a part of a broader condition of suffering, thus accepting the concept of “total pain” as Phosphoprotein phosphatase the specific connotation of the terminal patient. A2 – Control of anxiety and other psychological symptoms (not dying with fear) Psychological suffering is part of the “total pain” and is, as well as the physical symptoms, an objective of the palliative caring. Some of the documents refer specifically to anxiety and depression (i.e. WHO II, CANADA CHPCA I, USA AGS, USA AMA, USA ASCO I, AUSTRALIA ANZSPM I); others describe it as a broader constellation of discomforts associated with impending death (e.g. WMA I, USA AAHPM IV, USA ONS II). These are frequently linked to spiritual or social problems.