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.
Stubbs M, Gaviola M, Sunner C, Reis J.
Abstract: Grief and bereavement are profound yet underexplored aspects of nursing practice within residential aged care facilities. Registered nurses who work in these settings often form close emotional bonds with residents, making repeated exposure to death deeply impactful. This study aimed to depict the grief, loss, and bereavement experiences of registered nurses in aged care through an arts-based qualitative approach. Nine nurses participated in a one-hour creative session involving drawing or painting to express their experiences of grief and loss. The artworks and accompanying narratives were analysed using a combined deductive and inductive approach guided by Guillemin's adaptation of Rose's critical visual methodology framework. Three key themes emerged: (i) symbolic use of colour, where colours conveyed emotions such as grief, peace, and transformation; (ii) elements of transformation, with imagery evolving from depictions of death and turmoil to representations of acceptance and renewal; and (iii) meaningful motifs, where symbols such as butterflies, birds, and domes represented peace, connection, and spirituality. Collectively, the artworks illustrated how grief, while painful, can evolve into acceptance and peace through creative expression. This study demonstrates the capacity of arts-based methods to reveal the emotional complexity of grief among aged care nurses, highlighting symbolism and colour as powerful tools for emotional understanding. Integrating creative approaches into professional development and emotional support initiatives may enhance wellbeing, reduce burnout, and improve retention. Further research should explore the long-term emotional effects of grief and the therapeutic potential of structured creative interventions in nursing practice.
Tiansaard J, Bloomer MJ, Purtell L, Bonner A.
Background: Advance care planning enables adults to express their goals and preferences for future care. Advance care planning has been widely recognised in oncology and palliative care for decades, but its use in kidney care is variable.
Objectives: To examine interventions that promote advance care planning among adults with chronic kidney disease, including those receiving kidney replacement therapy.
Design: Systematic review.
Methods: A comprehensive search was conducted in six databases: PubMed, MEDLINE, CINAHL, PsycINFO, Scopus, and Embase. Studies published from databases inception to September 2024 were included. Two independent reviewers identified studies for full-text review and data extraction. Methodological quality was assessed using the Mixed Methods Appraisal Tool. The review protocol was registered in PROSPERO (CRD42024589958).
Results: Twenty-seven studies were included: 22 were quantitative (10 randomised and 12 non-randomised), three were qualitative, and two were mixed-methods designs. Most studies were conducted in the United States of America. Five main strategies to promote advance care planning uptake and improve outcomes were educating and training kidney healthcare professionals; implementing advance care planning conversations; providing educational resources; offering peer facilitators; and integrating palliative care teams. The synthesis of qualitative findings indicated that advance care planning discussions instilled hopefulness about the future and did not induce anxiety.
Conclusion: Advance care planning conversations combined with educational resources and peer support facilitators are likely to improve rates of advance care planning completions in this population, although further evidence is needed. Kidney healthcare professionals should be trained to initiate these conversations with all patients.
Tulloch K, Acordi Steffen J, Rosenberg JP.
Background: Although palliative care embraces person-centred principles and autonomy to meet patients' holistic needs, autonomy is not automatically assured and few studies cover patients' lived experiences. Consequently, current thinking about dying and palliative care practices would benefit from an in-depth understanding of patient experiences. Such research provides an opportunity to challenge assumptions about patient preferences for the amount and type of care and decision-making involvement, especially for the way patient preferences may vary between individuals and change through the palliative care process.
Objectives: This project aimed to investigate patient conceptualisations and preferences for autonomy while receiving palliative care.
Design: This qualitative phenomenological study explored patients' experiences of autonomy in home-based palliative care in Queensland, Australia.
Methods: Face-to-face semi-structured interviews were audio-recorded with two participants to learn their perspectives regarding autonomy in palliative care. Transcripts were analyzed using interpretative phenomenological analysis.
Results: Four themes were identified: (a) my involvement in healthcare decisions, (b) change to my autonomy during illness progression, (c) self-assessing my abilities to exercise autonomy and (d) my coping mechanisms for loss of autonomy. Palliative care patients perceived and managed their autonomy amidst their illnesses, revealing a sense of loss of autonomy extending beyond healthcare into many daily activities. Participants wished to exercise autonomy in nuanced ways, varying in intensity across many aspects of their lives, underscoring the importance of recognising and respecting individuals' wishes for autonomy.
Conclusion: Partnering with individuals receiving palliative care provided authentic insight into their level and experience of autonomy. While many health practitioners aim to facilitate autonomy in patients receiving palliative care, flexibility is required to recognise variable patient needs. Such approaches will further ensure autonomy moves beyond a singular view of healthcare decision participation, to encompass changes to preferences during palliative care, while recognising how patients exercise autonomy via self-assessment and coping mechanisms.
Bourne OP, Fischer A, Good P.
Objectives: This study aimed to determine the frequency and characteristics of patients discharged from a specialist community palliative care service, and the incidence, timing and reasons for discharge.
Methods: This retrospective audit reviewed admissions and discharges over a 6-year period, including demographics, length of admission, discharge reason and readmission status.
Results: Of the 5149 admissions, 17% were discharged and 22% were later readmitted. 19% of readmissions were again discharged. The main reason for discharge was having no specialist palliative care needs (53%), followed by patients moving out of the service catchment area (13%). Median length of stay before discharge was 141 days, and median time from discharge to readmission was 214 days.A small group of 32 patients was referred, reviewed and immediately discharged, and most had a non-malignant diagnosis and were male. The main reasons for immediate discharge was the absence of palliative care needs or the service not being needed or wanted. A third of these patients were later readmitted.
Conclusion: These data show that a substantial proportion of community specialist palliative care service patients are discharged. It raises further research questions around flexible models of care, validated discharge criteria and implementing quality measures on discharge.
Clapham S, Daveson B, Ayalew AA, Draper K, Hartati A, Reed K, et al.
Purpose: Palliative care is delivered across most healthcare settings, yet service capability remains poorly defined, limiting quality improvement. A clearer definition is essential to drive system-wide improvement. This scoping review was undertaken to answer two important questions: What are the key constructs that define palliative care service capability, and how can they inform quality improvement and benchmarking?
Methods: A scoping review, retrieving studies from Medline, PsycINFO, and CINAHL. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). Relevant literature published in English from the year 2000 onwards, focusing on palliative care service delivery, standards, quality, and outcomes were included. Data were organised using an evidence map to define service capability and develop a conceptual framework.
Results: Palliative care service capability is defined as the ability of a service to deliver care, shaped by the broader health system and organisation in which the service operates. Four core domains emerged as central to the concept and were mapped against existing standards, quality indicators and clinical frameworks: (1) assessment, planning, and care provision; (2) transitioning patients between services; (3) availability of care; and (4) collaboration and linkages across health services involved in delivering palliative care.
Conclusion: This review provides a definition and conceptual model for palliative care service capability to support quality assessment and facilitate meaningful benchmarking. Integrating this framework into national quality initiatives may help identify gaps in service and system delivery, standardise care processes, and enhance patient-centred outcomes.
Last updated 30 April 2024