What is the aim of research? 

The aim of research is to generate new knowledge. The National Health and Medical Research Council (NHMRC) is a major funder of research in Australia and offers the following on research: The concept of research is broad and includes the creation of new knowledge and/or the use of existing knowledge in a new and creative way to generate new concepts, methodologies, inventions, and understandings. This could include synthesis and analysis of previous research to the extent that it is new and creative. [1]

Starting point

An evidence gap, novel observation, or finding.

Goal

The creation of new knowledge.

Role of Evidence

Research outcomes that come closest to the facts form evidence. 

Palliative care research 

Conducting research in palliative care is complex. This partly reflects the diversity of populations and contexts of care. In research terms van der Steen [2] note that palliative care research includes a focus on a very diverse range of issues including:

  • patient values, wishes and goals of care
  • managing biopsychosocial symptoms
  • managing spiritual needs
  • improving quality of life
  • communication
  • decision-making
  • professional collaboration and teamwork.

The volume of research in palliative care is rapidly increasing but quality remains an obstacle to generating evidence. [2] There are many challenges that are unique to or significant in palliative care as a research setting:

  • The difficulty with recruiting and retaining study participants whose health is declining and who are approaching death
  • The need to include perspectives that reflect the multidisciplinary nature of palliative care provision
  • Problems with building collaborative research teams and conducting research across the range of settings in which palliative care is provided
  • Challenges related to identifying and contacting family members and caregivers who have been consumers of palliative care
  • The difficulty of how best to measure effectiveness and cost-effectiveness of treatments and services in the midst of inevitable deterioration in a dying patient
  • The challenges of engaging clinicians in a sector where there has not traditionally been a research culture. This includes building infrastructure, and building expertise in the range of different methodologies appropriate to different research questions in palliative care
  • The predominance of investigator-led over pharmaceutical company-led research in palliative care limits financing opportunities for researchers.


In an extensive review of research in palliative care, Bouca-Machado 2017 note – ‘the first step in generating not just valid, but also generalisable knowledge, is to clearly define palliative care populations, types of intervention and time to referral, establishing a common lexicon for clinicians and researchers’. [3] Almost a decade earlier, Currow [4] proposed a framework comprising five domains to standardise description of palliative care populations, providers, services, and policy and research contexts. This might improve generalisability across both quantitative and qualitative research.


Knowing where there is no evidence, i.e., evidence gaps, can also help you by indicating where to focus your research. From a clinical perspective evidence gaps may mean that you are more reliant on expert consensus and research conducted in other populations until an evidence base can be established.

See CareSearch Clinical Evidence (synopsis)

Clinical Evidence

CareSearch Clinical Evidence summaries for palliative care across the life-course and the palliAGED Evidence syntheses for care of older people both list gaps in palliative care evidence.

palliAGED Evidence Centre

palliAGED

You can learn more about research at the Research Centre for Palliative Care Death & Dying, RePaDD.

Visit the RePaDD website

RePaDD

  1. Australian Code for the Responsible Conduct of Research 2018. Canberra: National Health and Medical Research Council, Australian Research Council and Universities Australia. Commonwealth of Australia; 2018.
  2. van der Steen JT, Bloomer MJ, Martins Pereira S. The importance of methodology to palliative care research: A new article type for Palliative Medicine. Palliat Med. 2022 Jan;36(1):4-6. doi: 10.1177/02692163211069566. Epub 2021 Dec 29.
  3. Bouça-Machado R, Rosário M, Alarcão J, Correia-Guedes L, Abreu D, Ferreira JJ. Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting. BMC Palliat Care. 2017 Jan 25;16(1):10. doi: 10.1186/s12904-016-0181-9.
  4. Currow DC, Wheeler JL, Glare PA, Kaasa S, Abernethy AP. A framework for generalizability in palliative care. J Pain Symptom Manage. 2009 Mar;37(3):373-86. doi: 10.1016/j.jpainsymman.2008.03.020.

Page created 19 April 2022