Research methodologies in palliative care: a bibliometric analysis

Abstract

The aspiration to design and conduct high-quality research in palliative care has been an important but elusive goal. The article evaluates the nature of research methodologies presented in published research within the broad remit of palliative care. A systematic search of the Medline database between 1997 and 2006, using the keywords 'palliative care' or 'end-of-life care' and 'research methodology', identified over 318 publications. A bibliometric analysis indicates an incremental increase in published outputs per year, from 27 countries, with articles widely distributed across 108 journals. The heterogeneity of the research methodologies and the journals publishing them, present challenges in defining what constitutes 'high quality'. We argue that although this diversity leads to a lack of coherence for a single disciplinary paradigm for palliative care, there is a greater acknowledgement of the differing epistemological and theoretical frameworks used by researchers. This could be regarded as enriching our understanding of what it means to be dying in contemporary society.

An Evaluation of the Current State of Cancer-Related Palliative and Supportive Care Research in the UK

“…With respect to professions, the domination by nurses is clear and this was also the case in the 2004 analysis as well as the work by Payne & Turner [9] who stated that this is perhaps attributable to the growth of nursing scholarship in the past decade. Our results suggest a higher proportion of researchers that come from a nursing background to date (52% vs 36% in 2004) and may reflect a better career integration strategy for nursing.…”

“…Randomized controlled trials reflect research questions related to efficacy and effectiveness, and an increasing focus on such designs was a priority. This low number of trials is perhaps not surprising as much of palliative and supportive care has to do with providing service and care, and there is much less focus on interventions than in other areas of oncology perhaps as there may be formidable challenges and ethical issues in designing particularly end of life trials [8,9]. This is reflected in the high proportion of studies where qualitative methods are used (27%), often for data on patient experiences and perceptions, confirming past bibliometric analyses [9].…”

“…This low number of trials is perhaps not surprising as much of palliative and supportive care has to do with providing service and care, and there is much less focus on interventions than in other areas of oncology perhaps as there may be formidable challenges and ethical issues in designing particularly end of life trials [8,9]. This is reflected in the high proportion of studies where qualitative methods are used (27%), often for data on patient experiences and perceptions, confirming past bibliometric analyses [9]. Many studies used standardized validated measures, which allows some degree of comparisons to be made, although the descriptive nature of the studies are less likely to influence significant changes in practice.…”

Improving the Evidence Base in Palliative Care to Inform Practice and Policy: Thinking Outside the Box

“…25 The use of desirable alternative or delayed interventions for control groups, such as randomized fast-track 52 . Other approaches for understanding the complexity of patients' and family members' experiences that do not primarily rely on quantitative assessments and measures, including qualitative research methods, can also contribute to the advancement of palliative care 19,37 . It is also worth pointing out that qualitative studies provide important preliminary data to inform the development and subsequent validation of quantitative surveys.…”

“…Over the past two decades, numerous concerns regarding methodological issues and debates about the role of evidence-based approaches in palliative care research have been raised [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] . The purpose of this narrative review is to further explore the debate about the use of current evidence-based approaches, such as RCTs, for conducting research and evaluating the literature in palliative care, by addressing the following three questions:…”