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.
Bocks L, Viengkham C, Powell M, Considine J, Fry M, Curtis K, et al.
Aim: To understand the current evidence base regarding holistic nursing assessments performed by registered nurses in residential aged care homes in Australia, and identify the gaps in knowledge and potential areas for future research.
Design: A scoping review informed by JBI guidelines and the PRISMA extension for Scoping Reviews.
Methods: The electronic databases Medline, EMBASE, CINAHL, Scopus and ProQuest Central were searched, alongside citation chaining and manual journal searches. Limits of English language and publication after the year 2000 were applied. Studies were screened against pre-defined eligibility criteria. Data were extracted and analysed using descriptive statistics and a narrative synthesis.
Results: A total of 3987 studies were identified, of which 28 were categorised as comprehensive or multimodal assessment programmes, standalone assessment tools or assessment infrastructure papers. Key outcomes described included staff factors and resident emergency department transfers or hospitalisations. The key feature of existing nursing assessments across studies was education, which was generally associated with improved staff knowledge, confidence and efficiency. Apart from this, there was large heterogeneity among assessment interventions with inconsistent effects. Few studies focused on residents with dementia or palliative care needs.
Conclusions: There is currently no standardised, systematic approach to the holistic assessment of residents by registered nurses in Australia. This gap in assessment is especially evident for residents with dementia or palliative care needs.
Impact: This research highlights the need to develop standardised holistic nursing assessments to bridge this gap in practice.
Forsythe D, Davis K, Sharplin G, Swetenham K, Eckert M.
Abstract: Grief is a normal reaction to loss, but some bereaved people require structured support to adjust. This paper reports findings from phase one of a study to develop a statewide model for grief and bereavement support and assess the associated costs and benefits. A desktop review and online survey mapped existing supports and identified gaps in support. Semi-structured interviews provided further insight into areas of unmet need. Results showed existing grief supports for the general population, for targeted community bereavement care, and for specialised professional care, but a lack of integration between supports, challenges in identification and navigation of supports, and a gap in supports for diverse and rural populations. Supports to develop a grief-literate general population, and grief training for professionals were also needed. Identified gaps highlight preliminary key areas to be addressed in the selection or development of a model for statewide grief and bereavement support.
Lee W, Draper B, Agar MR, Currow DC.
Abstract: Clinically significant depressive symptoms are prevalent in advanced life-limiting illnesses. The assessment and management of such illness can be challenging for clinicians when prognoses are extremely short (days to weeks). Currently, evidence to guide practice is lacking, and there exists no guideline that specifically addresses depression care in this patient population. An approach, illustrated by the mnemonic "SCREENIN," is proposed in this commentary to optimize the care of individuals with depression when prognoses are extremely short. Even when prognosis is short, depression should still be routinely screened and promptly assessed, with proactive care delivered. There is an urgent need for clinician training, service linkage, research, and cultural change in this area through better collaboration between palliative care and psychiatry.
Allcroft P, De Pasquale CG, Lim D, Amgarth-Duff I, Agar MR.
Abstract: People with advanced heart failure experience significant biopsychosocial needs and have a poor prognosis. International guidelines have called for integrating palliative care in heart failure management. This review explores the elements of effective palliative care interventions in advanced heart failure. PubMed, Embase, CINAHL and Cochrane Reviews were searched following an a priori review protocol for clinical trials of advanced heart failure and palliative care. The risk of bias was assessed using Risk of Bias 2 (RoB2). A qualitative, emergent approach was used to synthesize context + mechanism = outcome. Twenty-one papers from 18 studies were the data source. The efficacy of palliative care in advanced heart failure was mixed. Five studies reported significant improvement in health outcomes compared with the usual care control group. Timing may be necessary in accounting for improvement in quality of life (occurring on or about 3 months) and functional and symptomatic improvements (occurring on or about 6 months or longer). Effective models of secondary palliative care in advanced heart failure include interdisciplinary teams comprising primary care, cardiology and palliative care, routine check-ins, personalized care plans that explore goals, evidence-based symptom management and counselling. Integrating palliative care with heart failure management could improve patient outcomes. Future research and policy development may wish to consider when, how and what palliative care modalities are to be incorporated into the care of patients with advanced heart failure.
Auret K, Pikora TJ, Briand BC.
Background: Voluntary assisted dying has become available as an end-of-life choice in many countries, including Australia. There is evidence on the mixed impact of voluntary assisted dying legislation on palliative care healthcare professionals, however, less is known about the interface between palliative care and voluntary assisted dying in smaller rural settings. This study explored the experiences of staff at a hospice in rural Western Australia in the two years following the implementation of voluntary assisted dying legislation.
Methods: A mixed-methods research methodology was used, with data collected via a brief anonymous survey and semi-structured interviews conducted with hospice staff in one rural location in Western Australia. Survey data was exported into SPSS and descriptive statistics were performed. Interviews were audio recorded and after deidentification, the transcripts were analysed thematically.
Results: A total of 30 participants took part in the survey and 10 were interviewed. The majority (n = 19) of survey respondents had been involved in voluntary assisted dying, yet only seven reported that their day-to-day role had changed. Supporting patient choice and autonomy were the most cited benefits of the introduction of voluntary assisted dying. Analysis of the qualitative data yielded three main themes: everyone is involved with patients accessing VAD; nothing changes but everything changes; and perceived support, education and training needs.
Conclusions: This study has described day-to-day work and experiences of those working in a small rural hospice which has integrated VAD into the care offered within the facility, observing there are subtle changes in the organisational atmosphere when VAD occurs. The education and support activities in place and the noted gaps may be a useful checklist for other hospices in the early phases of integrating VAD into their facility. Recommendations for future research are made.
Last updated 30 April 2024