Health services research in palliative and end of life care

2021 ◽  
pp. 1328-1334
Author(s):  
Tinne Smets ◽  
Luc Deliens
Keyword(s):  
Palliative Care ◽  
Health Services Research ◽  
Health Services ◽  
Medical Research ◽  
End Of Life ◽  
Research Council ◽  
Life Care ◽  
Services Research ◽  
Care Services ◽  
Palliative Care Services

Clear information about the effectiveness of services and interventions is often lacking in palliative care service planning. The development of palliative care services and interventions should be based on evidence that they will increase the likelihood of desired outcomes, but also understanding the process of the intervention and how it might work in practice are vital in building an evidence base that informs policy and practice. Health services research in palliative care covers topics such as palliative care needs, access to palliative care, quality of care and feasibility, effectiveness, and cost of palliative care services and interventions. Patients needing palliative care often have complex needs and require complex services and interventions. The Medical Research Council guidance for developing, evaluating, and implementing complex interventions, the MORECare statement on ‘best practice’ methods for research evaluating end of life care, and the Medical Research Council guidance on process evaluation offer useful support for researchers undertaking health services research. To evaluate complex services and interventions, a wide ranch of study designs can be used. Studies that enrol patients with advanced illness present unique challenges, both ethical and methodological.

Health services research in palliative care and end-of-life care

2015 ◽  
Author(s):  
Tinne Smets ◽  
Luc Deliens
Keyword(s):  
Palliative Care ◽  
Health Services Research ◽  
Health Services ◽  
End Of Life ◽  
End Of Life Care ◽  
Complex Interventions ◽  
Control Group ◽  
Life Care ◽  
Care Needs ◽  
Services Research

Health services research in palliative care and end-of-life care involves the study of palliative care needs, access and quality of palliative care, and the feasibility, effectiveness, and cost of palliative and end-of-life care services and interventions. The evaluation of services and interventions involving patients with advanced illness presents unique challenges, both ethical and methodological. In this chapter, several research designs that are useful for the service evaluation of complex interventions in palliative care and end-of-life care are discussed and examples of studies using these designs are described. The designs that are described include both experimental and non-experimental designs. The problems and challenges that doing research with dying patients presents are subsequently described and possible solutions proposed. The challenges dealt with in this chapter include defining the intervention, determining relevant outcome measures, randomization of patients to intervention and control group, achieving recruitment and minimizing attrition, heterogeneity of the patient group, and obtaining informed consent.

Effect of Palliative Care Services on the Aggressiveness of End-of-Life Care in the Veteran's Affairs Cancer Population

2011 ◽  
Vol 14 (11) ◽  
pp. 1231-1235 ◽  
Author(s):  
Wilson I. Gonsalves ◽  
Tsewang Tashi ◽  
Jairam Krishnamurthy ◽  
Tracy Davies ◽  
Stephanie Ortman ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Services ◽  
Palliative Care Services ◽  
Veteran's Affairs

scholarly journals The Association Between Home Palliative Care Services and Quality of End-of-Life Care Indicators in the Province of Québec

2015 ◽  
Vol 50 (1) ◽  
pp. 48-58 ◽  
Author(s):  
Bruno Gagnon ◽  
Lyne Nadeau ◽  
Susan Scott ◽  
Serge Dumont ◽  
Neil MacDonald ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Care Services ◽  
Palliative Care Services

scholarly journals STRENGTHENING OLDER INDIGENOUS NEW ZEALANDERS AT END OF LIFE: WHAT ROLE DO HEALTH SERVICES PLAY?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S668-S668
Author(s):  
Tess H Moeke-Maxwell ◽  
Kathleen R Mason ◽  
Merryn Gott
Keyword(s):  
Palliative Care ◽  
Older People ◽  
End Of Life ◽  
Indigenous People ◽  
End Of Life Care ◽  
Life Care ◽  
Care Services ◽  
Indigenous Plant ◽  
Palliative Care Services ◽  
Communal Sharing

Abstract Older indigenous people and their families draw on specific tribal care customs to support end-of-life care as these help to fortify and strengthen older people. New Zealand’s health and palliative care services can either help or hinder families to utilise their care customs. The aim of the Pae Herenga study was to investigate the specific traditional care customs employed by older New Zealand Māori. This involved 60 face-to-face interviews with participants who had a life limiting illness (majority aged over 65), family carers, indigenous healers, spiritual practitioners, and health and palliative care professionals across four key geographical sites. Three digital story workshops involving 16 participants were also included. The study findings show that no matter what the older person’s illness was, their cultural customs and protocols helped to fortify them and kept them spiritually safe at end-of-life. Hospitals and hospices helped families to action their customs by providing rooms large enough to host gatherings of thirty or more people; prayers, songs, speechmaking and communal sharing of food took place. However, incidences of racism, a lack of space, and a lack of support for indigenous plant medicines prevented the use of ancient traditional end-of-life care customs for older people. The findings suggest that health and palliative care services can help older indigenous people maintain their spiritual strength by providing them with culturally supportive care and environments equipped to host the dying and their families.

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