A Realist Synthesis
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We are a team of researchers from the School of Nursing and Midwifery, Queen’s University Belfast, Nuffield Department of Primary Care Health Sciences, University of Oxford, along with Patient and Public Involvement from the Northern Ireland Cancer Research Consumer Forum, the Marie Curie Voices Research group and the National Cancer Research Institute, Living with and beyond cancer executive. We are all passionate about improving the quality of life of people living with cancer and their loved ones.
Why is this research important?
Cancer is the second leading cause of death worldwide, with high rates across the United Kingdom. Although anyone of any age can get cancer, it happens much more often in older people (those over the age of 65). Palliative care can do much to reduce suffering for people with cancer as it focuses on adding to cancer care by treating the whole person – their physical, psychological, social, and spiritual needs. Palliative care is care that aims to make people feel better and do more of what they want to do, rather than aiming to cure them. This improves quality of life for both patients and their loved ones.
Both the public and health care professionals want more palliative care for patients suffering with cancer. However, at the moment palliative care is not usually integrated with cancer care. This means that many patients still suffer from symptoms that could be helped by a more integrated palliative and routine cancer management approach. In its simplest terms, integrated care is “appropriate people and services working together to provide appropriate quality care, in a timely manner, across all settings and appropriate to the needs of the person being cared for”.
Integrating palliative care with cancer services is complicated and challenging. Lots of different approaches have been tried but it is not clear which works best for patients. For example, integrated care might be given in hospital, to outpatients, or at home. It could be delivered by different health care professionals such as cancer doctors, GPs, community nurses, or occupational therapists. It might be a face-to-face service or done using a video-link. It might be focused on managing patients’ symptoms or planning future care. Because there are lots of ways of delivering integrated palliative and cancer care, we still do not know which approach is best for patients and their families, and this is what this research study will address.
going to do?
We want to understand how integrating palliative and cancer care could work in different healthcare settings, and for which groups of people, so we can recommend ways to improve services and the care provided for patients with cancer and their families. To do this, we will undertake a particular method of literature review called “realist synthesis” that looks at all types of literature from all over the world to identify ‘what works for whom, in what circumstances, how and why?’ The review will enable us to build a detailed understanding of which combined palliative and cancer care approaches are best, in which circumstances, for which patients.
What do we hope to achieve?
Our findings will be used to provide implications for policy and practice on how palliative and cancer care approaches can be integrated to maximise the potential for widespread implementation, reduce healthcare costs, and improve quality of life for patients and families. We will work closely with our stakeholder group to make sure the findings make sense to them and co-produce a ‘user guide’ that provides practical implications for healthcare providers, along with user friendly summaries for the public and patients. With help from our stakeholder group, we will get these out to key audiences (e.g. providers, the public and patients).
Funders Supporting us on our journey
This project is funded by the National Institute for Health Research (NIHR) HS&DR (NIHR152115). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.