Palliative care and the need for education - Do we know what makes a difference? A limited systematic review

Abstract

Caring for patients with progressive illness who need symptomatic and palliative care involves professionals as well as non-professionals. Within the variety of settings that may exist around a patient, education will be constantly needed. A limited systematic review was therefore conducted in order to highlight factors that influence informal adult education.

Methods Eight databases (covering all the years each database covered up to present date), the internet and twenty-two journals were searched. If not available on line, the journals were hand searched. Keywords were ‘professional - instruction - evidence’, combined. The search was augmented by contacting researchers and authors. We included studies describing any adult education setting outside the formally established educational setting (such as classroom/school/university). Outcomes were related to individual responses, not to groups as a whole. We excluded studies including children or those carried out in classroom settings, as well as studies where the outcome referred to the group as a whole. Data were extracted into tables and contrasted, drawing particularly on studies from health care settings. Studies were graded according to their: 1) relevance by using an adjusted Signal score and 2) level of evidence.

Results A total of 81 articles and reviews were found. From these, 28 studies and 5 Cochrane reviews were included. The studies and reviews reflect a spread in design, settings as well as origin. All continents except South America were represented. Many studies indicated that a multi-faceted, personally tailored educational approach gives the best results. This finding was corroborated by the Cochrane reviews. A common finding was that transport (to the educational arena) emerged as an important factor.

Conclusions Multifaceted education, which includes the use of various media, and which is personally tailored is most effective. Examples are such as a combination of verbal and written presentations including information forms, leaflets, alongside a demonstration of practical skills in a real life situation.