Palliative care in the Greater China region: a systematic review of needs, models and outcomes

Research output: Contribution to journalArticle

Authors

Colleges, School and Institutes

External organisations

  • King's College London

Abstract

Context: There is rapidly increasing need for palliative care in Greater China due to 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, 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 synthesised: pain control, reduced aggressive end-of-life care, truth telling, physical, emotional and spiritual support, and achieving preferred place of care/death. Informal caregivers expressed their needs for education and burden reduction. Healthcare professionals called for training and national policy support. Twenty-four studies evaluated interventions, mostly among advanced cancer patients. 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, psycho-spiritual assessment, quality of care, and implementation assessment. Limited rigorous randomised controlled trials is 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 non-malignant disease, and to integration into primary services. Policy support is key to establishing culturally appropriate person-centred services.

Details

Original languageEnglish
JournalJournal of Pain and Symptom Management
Early online date8 Sep 2020
Publication statusE-pub ahead of print - 8 Sep 2020

Keywords

  • Palliative care needs, interventions, outcomes, Greater China, systematic review