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.
Close E, Downie J, White BP.
Abstract: Canada's federal monitoring system for medical assistance in dying (MAiD) commenced in 2018 and was expanded in 2023 to enhance data collection. This article sought to understand the role of monitoring in the regulation of MAiD in Canada. It reports on qualitative interviews conducted with 68 participants from two key groups: MAiD assessors and providers; and "organizational actors" from a range of bodies including government, regulators, professional organizations, and healthcare organizations. Participants' views of the monitoring framework for MAiD were analyzed. There was consensus that monitoring should be distinguished from oversight. Participants thought the monitoring system provided important transparency into MAiD practice but emphasized mitigating burdens on practitioners, where possible. Methods of data collection varied, and a pan-Canadian approach was challenging. Participants had different views about the appropriate scope of data. The article concludes with recommendations for effective monitoring of assisted dying practices.
Forsythe D, Davis K.
Objective: This rapid scoping review was undertaken as part of a larger study to design a statewide operational model of grief and bereavement supports in South Australia. The aim of the review was to describe the structures, services, and components of supports offered by grief and bereavement programs in South Australia.
Methods: The review was preceded by a desktop review of gray literature and informed by the Joanna Briggs Institute methodology for scoping reviews. Databases searched included Cumulated Index in Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycINFO, and PubMed. Data were extracted about specific supports, services and programs, and imported into NVivo for thematic analysis.
Results: A total of 2383 articles were retrieved, with the findings from 88 articles extracted and included. Eleven themes relating to supports for grieving and bereaved people comprised: (1) follow-up bereavement care (with health professionals); (2) counseling support; (3) bereavement coordination; (4) peer support; (5) information about grief and loss; (6) referrals and risk assessment; (7) memorial services and mementos; (8) other practical and informal emotional supports; (9) personnel; (10) staff training; and (11) staff support.
Conclusions: This review advocates for including all identified supports in comprehensive grief and bereavement care. While implementing this in full may be challenging for individual services and providers due to time and resource constraints, integrating these components at a population level should be considered. Each element plays a role in delivering holistic care, requiring the combined efforts of community action and formal service provision.
Lambert E, Strickland K, Gibson J.
Purpose/ aim: To establish cultural considerations for people from culturally or linguistically diverse backgrounds at the end-of-life in Australia.
Background: Globally, there is a rapidly increasing proportion of the ageing population, and high levels of migration to Australia, the Australian healthcare community must recognise individualised and cultural needs when approaching death and end-of-life care. Many people from culturally and linguistically diverse backgrounds do not traditionally practice the palliative care approaches that have been developed and practised in Australia.
Design: A Critical Interpretive Synthesis.
Methods: A review protocol was established using PRISMA 2020 guidelines and the literature searched using CINAHL, PubMed, Psych INFO and Medline from January 2011 to 27th February 2021. This search protocol results in 19 peer-reviewed results for inclusion in critical analysis.
Results: Included studies were qualitative (14), quantitative (4) and mixed methods (1). Four themes were identified from the literature: (i) communication and health literacy; (ii) access to end-of-life care services; (iii) cultural norms, traditions and rituals; and (iv) cultural competence of healthcare workers.
Conclusions: Healthcare workers have an essential role in providing care to people with life-limiting illnesses. Cultural considerations during end-of-life care are imperative for the advancement of nursing practice. To achieve effective care for people of culturally and linguistically diverse backgrounds during end-of-life care, healthcare workers need to increase their education and cultural competency. There is inadequate research conducted within specific cultural groups, rural and remote Australian communities and individual cultural competence of healthcare workers.
Implications for practice: Continuing advancement within nursing practice relies on health professionals adopting a person-centred and culturally appropriate approach to care. To ensure individualised person-centred care is provided in a culturally appropriate way, healthcare workers must learn to reflect on their practice and actively advocate for people with culturally and linguistically diverse backgrounds during end-of-life care.
Pearce R, Steele P, Poon P.
Background: Palliative care patients undergoing transitions between hospital and home settings encounter significant challenges, necessitating specialised support services. The Rapid Palliative Care Inreach Division (RAPID) program was implemented to facilitate this transition utilising telehealth services.
Objectives: This study aimed to evaluate the use of telehealth modalities and their association with consultation interventions within the RAPID program.
Design: A retrospective clinical audit was conducted using electronic medical record data from patients seen by the RAPID palliative care service.
Setting/ subjects: The study took place in Australia, across a metropolitan health service. Data were collected from all patients referred to the RAPID program between October 2020 and March 2022, including those discharged home from inpatient palliative care or admitted under Hospital in the Home (HITH).
Measurements: Data included patient demographics, Palliative Care Outcomes Collaboration (PCOC) phase at each consultation, consultation modality (telephone, video, or in person), and intervention type (e.g. medication changes, education, referrals).
Results: A total of 201 patients received 722 consultations: 76.18% by telephone, 18.56% by video, and 5.26% in person. Patients from non-English speaking backgrounds more frequently received video and in-person reviews. Video consultations were associated with higher intervention rates, particularly in Stable and Deteriorating phases. Patients under HITH had longer service involvement and more interventions than community-discharged patients.
Conclusions: The RAPID program highlights the role of tailored telehealth in transitional palliative care. Video consultations were linked to more frequent interventions, suggesting a potential clinical benefit that warrants further research into patient-centred outcomes and optimal modality use.
Stevens SX, El-Katateny E, Addo IY, Street D, Booth C, Shaw J, et al.
Background: People receiving treatment for advanced cancer invest substantial portions of their survival time receiving healthcare, labelled the 'time toxicity' of treatment. Although qualitative research has examined the impact of time burden on patients and their caregivers, its influence on treatment decision-making is unclear.
Objective: Our objective was to explore treatment decision-making with patients with advanced gastrointestinal cancer, their caregivers, and oncologists, and unmask the role of time burden in those decisions. The objective was to inform the design of a subsequent discrete-choice experiment (DCE) investigating the importance of time burden in treatment decision-making.
Methods: A two-step process was used. Factors relevant to treatment decision-making were discussed as part of semi-structured interviews. Responses were analysed using thematic analysis with a focus on measurable themes relevant to the development of candidate attributes for a DCE. Second, we reviewed stated-preferences studies in the field of treatment decision-making in cancer and compared the results with the candidate attributes identified from interviews.
Results: Interviews with 45 participants (20 patients, 10 caregivers,15 gastrointestinal oncologists; 53% metropolitan) revealed 4 themes and 6 candidate attributes: expected survival benefit of treatment, impact of physical side effects, effect on day-to-day functioning, route of administration, healthcare contact days, and planned length of the treatment course. Review of 45 published studies yielded no additional attributes.
Conclusions: This study identified six candidate attributes for a forthcoming DCE on time burden in advanced cancer care. These findings support growing efforts to quantify and address time toxicity in cancer treatment decision-making.
Last updated 30 April 2024