The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Kinsman LD, Mooney G, Whiteford G, Lower T, Hobbs M, Morris B, et al.
Background: An advance care plan outlines a patient's wishes regarding medical treatment or goals of care in the case that they become unable to communicate or to make decisions. An advance care directive (ACD) is an advance care plan that has been formally recorded and has legal status. Despite ACDs playing an important role in person-centred end-of-life care, an earlier retrospective medical records audit demonstrated that only 11% (58/531) of people who died due to a terminal illness had an ACD.The aim of this project was to increase the proportion of patients with a terminal illness completing an ACD. A secondary outcome was to measure the impact of ACDs on hospital and intensive care unit (ICU) admissions in the last 6 months of life.This multifaceted project comprised (1) education for health professionals and the public; (2) individual support for patients on request; (3) development of online resources for health professionals and the general public; and (4) monthly team meetings.
Method: The proportion of ACDs completed and hospital and ICU admissions during the last 6 months of life, were extracted via medical record audits.Written consent was required for patients to participate, including being contacted by the project team and accessing their medical records.
Results: 112 patients consented to participate in the project and 109 (97%) completed an ACD. There was no reduction in the average number of hospital admissions, while ICU admissions reduced from 14% (n=74) to 0%.
Conclusion: The targeted, multifaceted approach to education and support for completion of ACDs, resulted in a significant increase in ACD completion and a major reduction in ICU admissions.
Perera M, Halahakone U, Senanayake S, Kularatna S, Parsonage W, Yates P, et al.
Background: Palliative care and supportive care provided in the home for people with heart failure can improve quality of life, caregiver wellbeing and reduce healthcare costs. Identifying components of home-based palliative and supportive care in heart failure is useful to inform tailored care to people with heart failure.
Aim: To identify and describe components of home-based palliative and supportive care in adults with heart failure.
Design: A scoping review was undertaken in accordance with Joanna Briggs Institute guidelines. The protocol was registered prospectively with the Open Science Framework (https://doi.org/10.17605/OSF.IO/GHCME).
Data sources: Embase, PubMed, CINAHL and Cochrane databases were searched from inception in May 2023 and re-run in January 2024. Original research focussed on palliative and supportive care in the home setting that included adults diagnosed with heart failure who have not undergone nor awaiting a heart transplant was included.
Results: Results were extracted from 13 papers based on eight studies. The findings highlight that nurses supported by a multidisciplinary team, providing symptom management, patient and carer education and discussion of goals of care and advance care planning, facilitates home-based palliative and supportive care for people with heart failure.
Conclusion: Ensuring patient and caregiver-centred care supported by a multidisciplinary team is essential to delivering home-based palliative and supportive care for people with heart failure. Further research focussed on the role of digital interventions in home-based palliative and supportive care, the composition of the multidisciplinary team and research which includes individuals across all stages of heart failure is needed.
Sundararajan K, Raith E, Hu R, Damarell RA, Subramaniam A, Anderson N, et al.
Objective: Protocol to explore what is known about communication between critical care providers and patients and families from culturally and linguistically diverse backgrounds (defined as people who are either from minority ethnic groups, non-English-speaking backgrounds who may have diverse cultural, linguistic, spiritual and religious affiliations and opinions) about death, dying, end-of-life care and organ donation in the intensive care unit (ICU).
Introduction: Patients from culturally and linguistically diverse backgrounds experience barriers to optimised care when admitted to the ICU. These barriers appear to derive from differences in language, cultural, societal and ethical expectations between patients, their families and healthcare professionals. These barriers may significantly impact the delivery of end-of-life care to patients from culturally and linguistically diverse backgrounds. Therefore, this has the potential for inadequate management of medical, psychological and existential distress.
Inclusion criteria: Studies of all designs reporting for adult (age ≥18 years) patients and family members from culturally and linguistically diverse backgrounds at end-of-life in the ICU setting will be included. Studies that report results for patients aged <18 years or that are based outside the ICU will be excluded.
Methods: Relevant sources will be retrieved, and their citation details will be imported into the Joanna Briggs Institute (JBI) System for the Unified Management, Assessment and Review of Information. This scoping review was guided by the JBI methodology for scoping reviews and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A systematic search was conducted in EBSCOhost, Web of Science, PubMed Central and SciELO, OVID Medline, CINAHL, and Scopus, limited to English-language publications, without date limitation. Key study characteristics and findings will be extracted using a data extraction tool developed by the reviewers. Anticipating heterogeneous study designs, findings will be presented as a thematic synthesis.
Ethics and dissemination: This is a protocol for a scoping review, formal ethics approval from the Human Research Ethics Committee (HREC) of the Local Health Network will be obtained for research projects that could potentially stem from this review and will then be subsequently disseminated through proper channels.
O'Connor M.
Abstract: This paper is a personal reflection on involvement in the development of the first voluntary assisted dying legislation in Australia. Points of contention are discussed, where plural values were evident, as the legislation progressed towards implementation. Finally, ongoing areas of difficulty with the legislation are listed, where further thought is required to ensure ease of access for those in need.
Phan H, Ngu B, Hsu CS, Chen SC.
Abstract: Life and death education is a distinct field of study that has potential life relevance for consideration (e.g., self-awareness and subsequent improvement of one's own health well-being). Existing research development, situating in different learning-sociocultural contexts, has provided consistent evidence that showcases the differing viewpoints of life functioning (e.g., what is the true meaning of life?) and the intricate nature of death and dying (e.g., a death ritual that closely associates with a particular cultural group). Some of the research studies undertaken indicate the effective use of 'philosophization' or the discourse of philosophical analysis, enabling individuals to philosophize, contemplate, and seek transpersonal understanding of the subject matters of life and death (e.g., can a state of 'spiritual transcendence' help to alleviate a person's fear of death?). Such discourse, interestingly, has offered some informative yields for enriching and meaningful life purposes - for example, the seeking to attain transpersonal understanding of life (e.g., what does a state of self-transcendence actually mean?) and/or transpersonal life experience may assist a senior citizen to cope with his mental health during a temporary health crisis. Our teaching and research interest of life and death education over the past decade has led us to consider one important line of inquiry for development: namely, the proposition of a 'universal' blueprint or framework of life and death education for curriculum development, teaching, and research purposes. We are cognizant of the fact that, to date, there is no clear consensus or agreement as to what one is expected (e.g., specific learning outcome) to teach students who wish to study and learn about life and death education. On this basis, the present theoretical article introduces a theoretical framework, termed as 'The Life + Death Education Framework' (e.g., for universities), to assist educators for their quality teaching and/or research inquiries of life and death education. We firmly believe that the Life + Death Education Framework can be universal and, in this case, apply to different learning-sociocultural contexts.
Last updated 30 April 2024