Patients’ preferences in palliative care: A systematic mixed studies review

Abstract

Background: It is necessary to develop palliative care to meet existing and future needs of patients and their families. It is important to include knowledge of patient preferences when developing high-quality palliative care services. Previous reviews have focused on patient preferences with regard to specific components of palliative care. There is a need to review research on patient’s combined preferences for all elements that constitute palliative care. Aim: The aim of this study is to identify preferences for palliative care among patients in the palliative phase of their illness, by synthesizing existing research. Data sources: Studies were retrieved by searching databases – the Cochrane Library, Medline, CINAHL, PsycINFO, Scopus and Sociological Abstracts – from 1946 to 2014, and by hand searching references in the studies included. Design: A systematic mixed studies review was conducted. Two reviewers independently selected studies for inclusion and extracted data according to the eligibility criteria. Data were synthesized using integrative thematic analysis. Results: The 13 qualitative and 10 quantitative studies identified included participants with different illnesses in various settings. Four themes emerged representing patient preferences for care. The theme ‘Living a meaningful life’ illustrated what patients strived for. The opportunity to focus on living required the presence of ‘Responsive healthcare personnel’, a ‘Responsive care environment’ and ‘Responsiveness in the organization of palliative care’. Conclusion: The four themes may be useful for guiding clinical practice and measurements of quality, with the overall goal of meeting future needs and improving quality in palliative care services to suit patients’ preferences.