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

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.

Palliative care and nursing in dissertations and theses in Portugal: a bibliometric study

“…Studies conducted in the scope of community, in populations suffering from non-oncological diseases and pediatric populations were scarce. In these areas of palliative care there are clear gaps in knowledge production, which could be explored in future research and are consistent with results of similar international studies (6,28) . The most investigated target populations were students/health professionals (38.51%), followed by patients (25.86%).…”

Palliative Care Research – A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012

“…Thus, to further develop PC research, critical analysis in terms of characteristics of national PC research is desirable. A limited number of national evaluations of research conducted in the field have been reported, and these show the field to be dominated by observational study designs and by a lack of measurement of outcomes, sampling limitations and strong emphasis on need‐based investigations . Further, in cases where national reviews of research have been reported, these are considered a baseline for future analysis of trends.…”

Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting

“…Today, the initiation of a treatment on the basis on what is believed to be effective is no longer considered good clinical practice [4]. A clinician in addition to his clinical expertise, must have access to the best available evidence, should carefully appraise its quality and assess its applicability to each individual patient [5, 6]. …”

“…Whilst this may be beneficial, questions exist around the type and quality of the research being undertaken. Previous reviews have concluded that PC studies were largely descriptive, with a wide variation in sample size, in demographic and clinical aspects and with a lack of use of recognised standard measures and consideration of key outcomes [5, 6, 9–12]. Visser et al [5] studied the reality of evidence-based practice in palliative care and highlighted additional problems like unpowered studies, recruitment difficulties and high attrition rates, inadequate duration of follow-up and difficulty in defining outcomes and avoiding performance bias [5, 9, 13].…”