Effectiveness of palliative care interventions offering social support to people with life-limiting illness-A systematic review

Abstract

Individuals managing the challenges of life‐limiting illness require adequate social support to maintain quality of life. Qualitative research reports that patients value highly the social support obtained in palliative care interventions such as day care and group therapies. This systematic review aims to summarise existing quantitative evidence on palliative care interventions that facilitate social support. Research literature was systematically searched using electronic databases and key journals. Searches returned a total of 6,247 unique titles of which sixteen were eligible for inclusion. Interventions include group therapies, group practical interventions and palliative day care. Outcome measures and study designs were heterogeneous. Only one study used a validated outcome measure of social support. Benefits were influenced by participant characteristics such as baseline distress. Partial economic evaluation was attempted by two studies. Methodological challenges include attrition and use of outcome measures that were insensitive to change. Statistically significant results were reported in psychological and physical domains. Evidence is limited due to methodological issues and a scarcity of quantitative research, particularly regarding long‐term benefits and cost‐effectiveness. Interventions may be more beneficial to some groups than others.

A Systematic Review in Support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care, Fourth Edition

“…Social support Adults Outcome: social support 1 SR 106 One review reported findings from a single RCT of group therapy for patients with life-limiting illness that showed no demonstrable difference in social support; the review did not report effect estimates.…”

Meaning in life and quality of life: comparison between palliative care patients and a representative sample of the Swiss population

“…In the general population, social integration concerns not only QOL but also survival (40). In the end of life context, a recent systematic review reported the effectiveness of palliative care interventions enhancing social support on the patients' psychological wellbeing (41). Our results also speak in favour of the development of "compassionate communities" that aim to strengthen and broaden this kind of social support (42).…”

Religião/espiritualidade e apoio social na melhoria da qualidade de vida da pessoa com cancro avançado

“…Outra estratégia para enfrentar a doença e impedir ou reduzir efeitos stressantes a longo prazo é o apoio social, que se refere a interações interpessoais que incluem apoio emocional, companheirismo e aconselhamento. O apoio social está relacionado a uma melhor QV e a redução da ansiedade e depressão em doentes com cancro avançado (Bradley, Lloyd-Williams, & Dowrick, 2018). Por outro lado, o isolamento social associa--se à diminuição do bem-estar, aumento da depressão, aumento da intensidade da dor, mortalidade e ao declínio cognitivo.…”

“…A limitação nas relações sociais pode advir do estigma que a doença e a morte representam. Ainda, a dor, fadiga e outros sintomas podem impedir o envolvimento social e, assim, a reduzir a funcionalidade física, o que aumenta a restrição social (Bradley et al, 2018).…”