Palliative care research on the island of Ireland over the last decade: a systematic review and thematic analysis of peer reviewed publications

Sonja J Mcilfatrick,Tara Murphy

doi:10.1186/1472-684x-12-33

Abstract

BackgroundAs palliative care research continues to expand across Europe, and the world, questions exist about the nature and type of research undertaken in addition to the research priorities for the future. This systematic review, which is the first stage of a larger scale study to identify the research priorities for palliative care on the island of Ireland, examined palliative care research conducted on the island over the last decade.MethodsA comprehensive search strategy was implemented and strict eligibility criteria were applied in order to identify relevant peer-reviewed journal articles. Inclusion criteria were all of the palliative care studies undertaken on the island of Ireland and published between January 2002 and May 2012. These were assessed in relation to year, setting, sample size, research methodology, and relevant findings.Results412 publications were identified for screening and their abstracts obtained. After eliminating articles that did not meet the inclusion criteria, 151 remained for further analysis. A thematic analysis of 128 studies published between 2006 and 2012 revealed eight core themes: (1) specific groups/populations; (2) services and settings; (3) management of symptoms (physical, psychological, social); (4) bereavement; (5) communication and education; (6) death and dying; (7) spirituality; and (8) complementary and alternative medicine/intervention (CAM). There was an upward trend in the number of publications in palliative care research over the last ten years with over 72% of studies being published within the previous four years. A slightly higher number of studies were quantitative in nature (surveys, questionnaires, standardised assessments) followed by qualitative (individual and focus group interviews, case studies, documentary analysis and retrospective case note reviews), mixed methods, and systematic reviews.ConclusionsWhilst there has been a welcome growth in palliative care research across Ireland, this has largely been needs-based and small scale studies. In contrast, international researchers and decision makers recommend the need for more outcomes focused multidisciplinary research. An examination of palliative care research is an essential first step in seeking to develop future priority areas for further research, highlighting opportunities for future collaboration both nationally and internationally.

Highlights

As palliative care research continues to expand across Europe, and the world, questions exist about the nature and type of research undertaken in addition to the research priorities for the future
Changing demographic trends including an ageing population, increased life expectancy for individuals living with life-limiting illnesses, and the impact of illness on individuals’ physical, psychological and social wellbeing means that the demand for high quality palliative care services is expected to increase [1]
A combination of the following search terms were used with the Boolean phrase ‘and/or’ in order to maximise the type and range of material captured in the search: (“palliative” or “hospice” or “terminal” or “end-of-life”), (“palliative care” or “hospice care” or “terminal care” or “end-of-life care”), (“dying” or “death” or “terminal” or “terminally”), (“palliative” or “palliation” or “palliating” or “palliate” or “palliatively” or “palliat”), (“malignant” or “non-malignant”), (“pain” or “pain management” or “pain prevention” or “pain control”), (“symptom(s)” or “symptom management”), (“bereavement” or “bereaved” or “grief” or “grieving”), (“service design” or “service delivery” or “intervention”)

Summary

Introduction

As palliative care research continues to expand across Europe, and the world, questions exist about the nature and type of research undertaken in addition to the research priorities for the future. This is predicted to coincide with an increase in disease prevalence between 2007 and 2021 for diseases including cancer as well as chronic conditions such as cardiovascular and respiratory diseases [7] Data such as this has serious implications on palliative care service provision as estimates show that each year, 1.6 million cancer patients in Europe experience pain related to their disease, one third of them will require complex treatment and a significant number experience distressing symptoms [8]. This picture is further complicated by ongoing economic challenges, resulting in cuts to services, staff numbers and resources. Research that can inform evidence-based practice and demonstrate improved outcomes and cost effectiveness for a range of services and interventions in palliative care is required [9,10,11]

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