A systematic review and critical interpretive synthesis of public perceptions of palliative care

Gill, Andrew James

Abstract

Introduction
Professional and public misperceptions about palliative care are common and may contribute to poor palliative care access in different settings globally. In this thesis, I aimed to better understand these public perceptions and the influences on them.
Methods
A systematic literature review and critical interpretive synthesis was conducted. Non-medical subject headings for palliative care and perceptions were used to search for relevant quantitative, qualitative, and mixed-methods studies in MEDLINE, EMBASE, PsycINFO, CINAHL and, Web of Science Social Science Citations Index Expanded and Conference Proceedings Citation Index from 1 Jan 2002 to 31 May 2020. Search results were screened against a priori inclusion criteria, data extracted, and quality appraised by two independent researchers. Data were analysed by narrative quantitative synthesis, qualitative thematic synthesis, and then combined in a critical interpretive synthesis.
Results
48/33985 studies from Europe, North America, Asia and Australasia were included (32 quantitative, 9 qualitative, 7 mixed methods), representing 32585 members of the public (aged 18-101 years; 54% women). Knowledge of palliative care was poor (especially for men, younger people, and ethnic minorities) with considerable variation in public perceptions. A perception consistent around the world is “palliative care is death”. To some, this is euthanasia and giving up, to others it is comfort care allowing a natural death. Personal experience of palliative care improves understanding. In this context it is generally seen as good care offered by compassionate people – albeit still to be avoided until unavoidable.
Conclusion
Public understanding of palliative care is poor. Perceptions of palliative care are influenced by a triad of culture, socioeconomic position, and health literacy. To improve integration of a country’s palliative care services and improve access to palliative care, an intervention to increase exposure to and education in palliative care that considers these factors is needed.

Citation

Gill, A. J. A systematic review and critical interpretive synthesis of public perceptions of palliative care. (Thesis). Hull York Medical School, the University of Hull and the University of York. https://hull-repository.worktribe.com/output/4223148

• Thesis Type: Thesis
• Deposit Date: May 11, 2021
• Publicly Available Date: Feb 23, 2023
• Keywords: Medicine
• Public URL: https://hull-repository.worktribe.com/output/4223148
• Additional Information: Hull York Medical School, The University of Hull and the University of York
• Award Date: Nov 1, 2020