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Systematic review palliative care BMZ2024
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Systematic review about palliative care comparing 5 articles, including introduction, method (PRISMA), results, and discussion
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EFFECTIVE PALLIATIVE CAREINTERVENTIONS TO IMPROVE THE
QUALITY OF LIFE OF NURSING HOME
RESIDENTS: A SYSTEMATIC REVIEW
,Table of Contents
Abstract:............................................................................................................................1
1 Introduction....................................................................................................................2
2 Methods..........................................................................................................................3
2.1 Design.....................................................................................................................................3
2.2 Search Strategy.......................................................................................................................3
2.3 In- and exclusion criteria.........................................................................................................4
2.4 Study Screening and Data Extraction......................................................................................5
2.5 Methodological quality assessment........................................................................................5
3 Results............................................................................................................................6
3.1 Search Results.........................................................................................................................6
3.2 Results of the methodological quality appraisal......................................................................6
3.3 Results of the systematic review.............................................................................................7
4 Discussion......................................................................................................................11
References........................................................................................................................13
Abstract:
Introduction: Palliative care is a type of specialized medical care that uses different
approaches to improve the quality of life for people with serious illnesses. The benefits of
palliative care include better QoL for patients. However, nursing homes often lack knowledge
and skills in providing palliative care, and interventions are needed to optimize it. The aim of
this study is to identify which interventions that aim to optimize palliative care influence the
quality of life in nursing home residents.
Methods: The study design was a systematic review. The PubMed database was searched in
February 2023, including only experimental study designs published from 2000+. The study
population should be NH residents who receive palliative care over the age of 65. The
outcome measure should measure QoL. The included articles were conducted following the
PRISMA flow diagram. The JBI critical appraisal tool was used to perform the
methodological quality assessment.
Results: Five studies are included in the systematic review, two of the included articles were
RCTs; three were quasi-experimental studies. Three out of the five articles which were
reviewed showed a positive influence on the QoL. One article did not show an increase in the
1
, QoL, but the control group decreased significantly, whereas the intervention group stayed
consistent.
Discussion: Overall findings are promising for the improvement of quality of care for NH
residents by educating the staff. However, further research is necessary to obtain more insight
into the different interventions for optimizing palliative care and the effect on the quality of
life in NH residents.
1 Introduction
Palliative care is a type of specialized medical care that uses different approaches to improve
the quality of life for people with serious illnesses, regardless of the stage of the disease
(Mounsley et al., 2018). It is given to a patient in their last days of life and helps to relieve
pain symptoms by detecting them early, assessing them carefully, and treating them
physically, psychologically, socially, and spiritually (Palliaweb, n.d.). Considering all these
aspects, palliative care has become a more active, holistic form of care (Radbruch et al.,
2020). According to the World Health Organisation (2020), patients have the right to receive
palliative care and make decisions about their treatment. This also includes the refusal of the
treatment. Not only does palliative care focus on patients' quality of life, but families and
caregivers are also considered (Akard et al., 2019). When a patient is not able to decide for
himself, caregivers can ask family members a ‘surprise question’: “Would you be surprised if
this patient dies within one year?” to easily identify whether the patient requires palliative
care (Weijers et al. 2018). If the answer is “no”, the patient should get palliative care
(Palliaweb, n.d.).
The benefits of palliative care in comparison with usual care is better quality of life of
patients in general and having fewer depressing thoughts about the situation. Quality of life is
important for patients in their end-of-life phase because it can significantly influence their
well-being, satisfaction, and overall experience during this time (Bruntink, 2021). Patients
who receive palliative care have better quality of life compared to those who did not receive
it. Therefore, palliative care can help to improve quality of life by addressing physical,
emotional, and spiritual needs (Seow et al., 2014).
Palliative care can be given at home, in a health care institution, or in a hospice. This
depends on the wishes of the patient. Nursing homes are becoming a more common place for
the delivery of end-of-life care for older people. They often represent the transition from
curative to palliative care (Gonella et al., 2019). Nursing homes strive to provide good care
for older people. Still, when it comes to palliative care, studies have shown that healthcare
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