Demystifying a Palliative Approach
This poster was presented by presented at the 20th International Congress on Palliative Care in Montreal, Quebec, September 9 - 12, 2014, by iPANEL team members Richard Sawatzky, Kelli Stajduhar, Patricia Porterfield, Joyce Lee and Kathleen Lounsbury.
A palliative approach pertains to the integration of principles of palliative care in contexts of care for people with chronic life-limiting illnesses and their families. As part of a program of research addressing how and in which contexts a palliative approach can better meet the needs of people with chronic life-limiting conditions and their family members, the iPANEL team (Initiative for a Palliative Approach in Nursing: Evidence and Leadership – www.ipanel.ca) is pursuing several broadly oriented research questions relevant to a palliative approach. A core focus involves an overarching knowledge synthesis regarding health care systems policy, education, and practice initiatives for a palliative approach. This poster reports on one aspect of the knowledge synthesis, focusing specifically on delineating the key characteristics of a palliative approach that are found in the empiric literature in order to establish conceptual clarity.
In collaboration with a large knowledge translation team, we identified search terms pertaining to “palliative care principles” and “chronic life-limiting conditions”. A comprehensive database search yielded 73 studies. Narrative synthesis methods and thematic analysis were used to identify and conceptualize essential characteristics of a palliative approach.
Our review revealed a burgeoning body of knowledge about a palliative approach, which can be conceptualized in terms of the following three overarching themes: (1) Upstream orientation towards the needs of people who have life-limiting illness and their families. (2) Adaptation of palliative care knowledge and expertise. (3) Operationalization of a palliative approach through integration into systems and models of care that do not specialize in palliative care.
Our synthesis produced much needed conceptual clarity regarding a palliative approach and its delineation from palliative care. Such clarity is of fundamental importance for the development of knowledge regarding the integration of a palliative approach in the care of people with chronic life-limiting illnesses.