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.
Winsall M, Devery K, Phelan C.
Aim: To explore the key advice healthcare professionals would give colleagues regarding end-of-life care delivery in hospitals, thereby informing training needs.
Design: Exploratory qualitative study.
Methods: Free-text responses from medical, nursing, and allied health professionals who completed online end-of-life care education modules (n = 597) from August 2022 to September 2023 were analysed using inductive content analysis. Results were explored and separated into two key findings: themes that were shared by all professional groups and themes that were profession specific.
Results: Five themes were consistent across all three professional groups: prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing, each with their own subthemes. Several profession specific subthemes were also identified.
Conclusion: The identification of common themes across healthcare professions helps to support the development of interprofessional training initiatives.
Implications for profession and/ or patient care: This research contributes valuable insights for developing targeted end-of-life care education programs. Results also underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
Impact: In Australia, most deaths occur in acute hospital settings. To inform and shape future training, this study collected the key advice healthcare professionals would give colleagues regarding end-of-life care delivery. The themes generated covered a range of potential training topics shared across all professionals, including prioritise patient comfort, proactive communication, collaboration and inclusion, human approach and support and wellbeing. Several profession-specific subthemes were also identified, providing additional insights for designing training for professional groups. Results underscore the potential of online learning platforms in providing accessible, evidence-based, continuing professional development in end-of-life care.
Yeo ZWE, Tieman J, George S, Farrer O.
Objective: Palliative and end-of-life care should be considered core business for aged care and healthcare teams in these settings. With a growing ageing population, the primary care workforce faces growing demand to deliver palliative care. This study aimed to explore the experiences of allied health clinicians and tertiary educators working in, and teaching, palliative care with an ageing focus in Australia.
Methods: We undertook a qualitative study using semi-structured interviews with clinicians experienced in aged and palliative care and tertiary educators delivering aged and palliative care curriculum content from four allied health disciplines (dietetics, occupational therapy, physiotherapy, speech pathology). Guided by critical realism ontology and a constructivist epistemology, reflexive thematic analysis was used for data analysis.
Results: Eleven participants were interviewed. Thematic analysis yielded two key themes and five subthemes. The two key themes were: (i) Barriers to best practice (n=4 subthemes) and (ii) Enablers of palliative care best practice (n=2 subthemes). Key barriers were that curriculum content is lacking and the medical model limits the volume and quality of care delivered. Enablers to quality care were self-directed learning and clinical experience.
Conclusion: Palliative and end-of-life care in aged care should foster reablement to support continuing agency and dignity through person-centred care. Allied health professionals are well-positioned to support this approach. However, facilitating allied health best practice will require addressing the reported barriers, including clinician preparedness and funding sufficient to meet demand and need.
Zhou M, Dray J, Parkinson A, Richardson A, Clynes L, Desborough J.
Background: Despite growing recognition of the importance of consumer engagement in advancing consumer-oriented and relevant research, many researchers experience challenges in appropriately acknowledging consumers' contributions to the research process. A pivotal aspect of this challenge relates to the financial remuneration offered to consumers in recognition of their contributions to research in terms of time, skills and expertise. This may be due to a lack and inconsistency of reported practice and guidance regarding remuneration. We sought to explore current practices for recognising consumers' contribution to health research and to understand health organisations' experiences and perspectives regarding this.
Methods: A working group convened by Research Australia comprised of two academics, one PhD candidate and eight health research organisation representatives, including consumer-led organisations, was established to develop a survey to elucidate current consumer remuneration practices in Australia. Drawing on existing consumer engagement literature, the draft survey questions were constructed and finalised following review, discussion and reaching consensus among the working group. The survey was distributed online to 503 research organisation participants across Australia from December 2023 to February 2024. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed using content analysis methods.
Results/ findings: 124 completed surveys were returned (25% response rate). 92% of participants supported recognition of consumer contributions to health research. Of this, 56% provided financial remuneration, while 36% provided non-financial forms of recognition, such as training and acknowledgement of academic outputs. However, recognition methods used in practice differed, and rates of financial remuneration varied across different levels of engagement. The need for national guidelines in consumer remuneration practice was expressed by 93% of participants.
Implications/ key mesage: These survey findings support an imperative to establish national recommendations for consumer remuneration, tailored to the needs of different organisations and contexts in Australia.
Patient and public contribution: A working group formed with eight member organisations from Research Australia, including consumer-led organisations, contributed to the survey development and interpretation of the qualitative findings by reflecting on the themes developed.
Alan JJ, Laging B, Cameron P, Laging R, Boyd J, Porock D, et al.
Objective: To explore emergency hospitalisations from Victorian residential aged care facilities (RACFs).
Methods: Retrospective descriptive study of Victorian RACFs transfers to ED from 2015/16 to 2022/23.
Main outcome measures: (1) ED event rate per 100 RACF beds; (2) Number of ED events, day/time, triage category, reason, comorbidity profile, length of stay, death within 12 months of ED presentation and costs; (3) Relationship between resident characteristics and total ED events; (4) Number of inpatient events, comorbidity profile, length of stay, intensive care use, preventable hospitalisations, diagnosis-related group, deaths and costs.
Results: The rate of ED presentations from Victorian RACFs from 2015/16 to 2022/23 ranged from 77 to 91 ED events per 100 RACF beds. Associated costs for ED and inpatient stay were over $2.8B. An advance care directive or substitute decision maker was unavailable for 84% of ED events. Eighty-seven per cent of residents presenting to ED were admitted; 90% for medical DRGs. Sixteen per cent of inpatient stays were potentially preventable under the national definition.
Conclusion: Victorian RACF residents make substantial use of hospitals. This study highlights a significant gap in advance care planning (ACP), with causes potentially linked to inadequate planning, poor document quality or lack of accessibility. To enhance hospital-RACF interactions, it is essential to identify and address unmet palliative care needs at policy, planning, and practice levels, ensuring person-centred care for residents in their final years.
Bartley N, Rodriguez Grieve L, Kirsten L, Wilson C, Sajish B, Shaw J.
Abstract: This research explored current practices, gaps in services and resources, and identified barriers and facilitators to implementing a bereavement model of care in an Australian health setting. We conducted 34 interviews with staff/volunteers who provide bereavement care to explore their practice and perceptions of care delivery. Five themes were identified through thematic and framework analysis: 1. Conceptualisation of bereavement was setting dependent; 2. Formal versus informal delivery of care; 3. Current bereavement care, referral pathways, and evaluation; 4. Barriers and Facilitators to accessing and providing care; 5. An ideal bereavement model of care. This research highlighted gaps in services and suggests a disconnect between current practice and ideal bereavement care delivery. We present an evidence-based bereaved-centred model of care, that can be tailored to fit specific health context and settings. Identified barriers and facilitators to implementing this model of care should inform strategies that underpin implementation of the model.
Last updated 30 April 2024