TY - JOUR
T1 - Palliative care in the Greater China region
T2 - a systematic review of needs, models and outcomes
AU - Chung, Huei
AU - Harding, Richard
AU - Guo, Ping
N1 - Funding Information:
H. C. received funding from the Taipei City Hospital, Taipei, Taiwan (grant number: 106XDAA00208). P. G. and R. H. conceived the idea for the study. P. G. and H. C. developed the protocol and conducted the data extraction, synthesis, and quality assessments. H. C. wrote the first draft of the article. All authors contributed to the interpretation of findings and critical revision of the article. All authors approved the final version of the article for submission. The authors declare no conflicts of interest.
Funding Information:
H. C. received funding from the Taipei City Hospital , Taipei, Taiwan (grant number: 106XDAA00208 ). P. G. and R. H. conceived the idea for the study. P. G. and H. C. developed the protocol and conducted the data extraction, synthesis, and quality assessments. H. C. wrote the first draft of the article. All authors contributed to the interpretation of findings and critical revision of the article. All authors approved the final version of the article for submission. The authors declare no conflicts of interest.
Publisher Copyright:
© 2020 American Academy of Hospice and Palliative Medicine
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Context: There is rapidly increasing need for palliative care in Greater China because of rapidly aging populations. Objectives: This study aimed to systematically review and appraise evidence for palliative care needs, models of care, interventions, and outcomes in Greater China. Methods: Four databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) were searched, with hand searching of local journals and databases. Narrative synthesis was applied to the qualitative and quantitative evidence. Results: Nineteen qualitative studies and 47 quantitative studies were retained. With respect to care needs, nine themes were synthesized: pain control, reduced aggressive end-of-life care, truth telling, physical, emotional, and spiritual supports, and achieving preferred place of care/death. Informal caregivers expressed their needs for education and burden reduction. Health care professionals called for training and national policy support. Twenty-four studies evaluated interventions, mostly among patients with advanced cancer. Positive effects were suggested for improvements in quality of life, pain, anxiety and depression, readmission rate, and costs. Models of care evaluated were mostly specialist palliative care delivered in various settings (hospitals, residential care, and home). Outcome measures used were grouped into six categories of construct: quality of life, pain, physical assessment, psychospiritual assessment, quality of care, and implementation assessment. Limited rigorous randomized controlled trials are available to document intervention outcomes, and some problems (such as high attrition rates) reduced the strength of the evidence. Conclusion: Palliative care services within Greater China should pay more attention to management of nonmalignant disease and to integration into primary services. Policy support is key to establishing culturally appropriate person-centered services.
AB - Context: There is rapidly increasing need for palliative care in Greater China because of rapidly aging populations. Objectives: This study aimed to systematically review and appraise evidence for palliative care needs, models of care, interventions, and outcomes in Greater China. Methods: Four databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) were searched, with hand searching of local journals and databases. Narrative synthesis was applied to the qualitative and quantitative evidence. Results: Nineteen qualitative studies and 47 quantitative studies were retained. With respect to care needs, nine themes were synthesized: pain control, reduced aggressive end-of-life care, truth telling, physical, emotional, and spiritual supports, and achieving preferred place of care/death. Informal caregivers expressed their needs for education and burden reduction. Health care professionals called for training and national policy support. Twenty-four studies evaluated interventions, mostly among patients with advanced cancer. Positive effects were suggested for improvements in quality of life, pain, anxiety and depression, readmission rate, and costs. Models of care evaluated were mostly specialist palliative care delivered in various settings (hospitals, residential care, and home). Outcome measures used were grouped into six categories of construct: quality of life, pain, physical assessment, psychospiritual assessment, quality of care, and implementation assessment. Limited rigorous randomized controlled trials are available to document intervention outcomes, and some problems (such as high attrition rates) reduced the strength of the evidence. Conclusion: Palliative care services within Greater China should pay more attention to management of nonmalignant disease and to integration into primary services. Policy support is key to establishing culturally appropriate person-centered services.
KW - Greater China
KW - Palliative care needs
KW - interventions
KW - outcomes
KW - systematic review
UR - http://www.scopus.com/inward/record.url?scp=85092486300&partnerID=8YFLogxK
U2 - 10.1016/j.jpainsymman.2020.08.040
DO - 10.1016/j.jpainsymman.2020.08.040
M3 - Review article
C2 - 32916261
SN - 0885-3924
VL - 61
SP - 585
EP - 612
JO - Journal of pain and symptom management
JF - Journal of pain and symptom management
IS - 3
ER -
