The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Bayuo J, Kyei Baffour P, Oduro EB, Adedibu D.
Background: The death of a loved one invariably triggers a complex constellation of profound emotional, psychological, and physical grief reactions. While theoretical frameworks for understanding the grieving process are well-established, the advent of assisted dying presents a novel and under-examined context for grief and bereavement. Thus, this study sought to generate a theory explaining the grieving process of family members involved in assisted dying.
Methods: A grounded formal theory approach was employed. Extensive systematic searches were undertaken across various four databases for eligible qualitative studies. Constant comparison was employed to iteratively refine emerging codes and categories.
Results: Fifteen (15) qualitative studies were retained. Reconciling, emerged as central to conceptualising the grieving process associated with assisted dying reflecting four interconnected categories: navigating ambivalence, anticipating, transitioning, and navigating the aftermath. This process is characterised as a complex, iterative, and often non-linear proactive journey of meaning-making, through which families strive to integrate the profound dichotomies. Reconciling, as a mid-range theory, extends existing grief models by demonstrating that bereavement in assisted dying involves a proactive, ethically charged negotiation of autonomy, suffering, and relational responsibility; dimensions not accounted for in stage-based or oscillation models.
Conclusion: The grieving process in assisted dying is best understood as Reconciling, a dynamic, iterative negotiation of autonomy, suffering, love, and loss. Families move through ambivalence, anticipation, transition, and aftermath in ways that blend emotional complexity with profound meaning-making. This theory offers a transferable framework to understand and support families navigating this ethically charged form of bereavement.
Jonescu EE, Farrell B, Ramanayaka CE, Delaney L, Litton E, Uylaki TJ, et al.
Abstract: The physical environment of inpatient wards plays a critical role in supporting rest and care delivery. In palliative care, environmental conditions such as sound, lighting, and temperature directly influence patient comfort, circadian rhythms, and staff performance. However, few studies have quantitatively assessed these factors in functioning palliative care units (PCUs).ObjectivesTo evaluate the spatial and environmental performance of an acute PCU through sensor-based monitoring of acoustic exposure, light levels, and temperature.MethodA postoccupancy evaluation approach was employed to assess conditions within inpatient rooms. Environmental loggers recorded data continuously at 1-min intervals across two 1-month periods. Parameters included sound levels (Lmax, Leq, Lmin in A-weighted decibels) to reflect perceived loudness, lighting (lux), and temperature (°C). Measurements were benchmarked against World Health Organization and Australian guidelines for sleep-supportive healthcare environments. Data were collected from both single- and multibed rooms in a metropolitan tertiary hospital PCU.ResultsSound levels frequently exceeded recommended thresholds. Nighttime averages reached 54 dB(A), while daytime LAeq exceeded 60 dB(A), with minimal day-night variation (<6 dB), indicating sustained exposure. Lighting data showed repeated nighttime spikes above 20 lux and insufficient daytime illumination for circadian regulation. Temperature exhibited minimal diurnal variation (<2°C), falling short of conditions known to support sleep.ConclusionEnvironmental monitoring revealed persistent deviations from sleep-supportive conditions. These stressors likely impact both patient well-being and staff performance. Findings underscore the need for evidence-based design strategies and translational research that position the built environment as an active contributor to holistic care. In palliative contexts, architectural design should enable rather than simply contain clinical practice.
Power J, Luckett T, McNeill R, Currow D, Landers A, Crawford GB, et al.
Background: Palliative care patients experience complex symptoms requiring varied pharmacological management. Medication choice depends on the underlying aetiology of symptoms, guideline recommendations, clinician preference and medication availability.
Aim: The aim of this study was to canvass the views of practising Australian and New Zealand medical practitioners practising palliative care regarding the medications they perceive to be essential for managing prevalent end-of-life symptoms, in an update to a previous clinician survey conducted in 2000. This study also canvassed respondents' views on whether patients experienced difficulties accessing these medications.
Methods: A cross-sectional survey was conducted in 2022 among current members of the Australian and New Zealand Society of Palliative Medicine (ANZSPM). The questionnaire explored ideal pharmacological management for 19 different symptoms experienced at the end of life. A descriptive analysis of results was calculated in SPSS version 28.0.
Results: Survey reponses were received from 13.5% of ANZSPM members. For most symptoms (n = 70), a large number of medications were listed as essential. The most concordant first-ranked medications included hyoscine butylbromide for noisy breathing (48.8%), benzodiazepines for breathlessness (nominated by respondents as a class, 41.2%), dexamethasone for cachexia (36.4%) and morphine for cough (35.5%). Respondents most frequently indicated there was no essential medication for oral ulceration, dry mouth, delirium and anorexia. Lidocaine for oral ulceration was ranked the most difficult for patients to access in the community (85.7%).
Conclusions: There remains various opinions on essential medications for palliative care. This suggests the need for ongoing research to reach an evidence-based consensus for clinical practice.
Tikhe D, Nhira P, Kepreotis M, Day F.
Aims: Resuscitation plans document the mutually agreed medical care of hospital inpatients in an acute deterioration, including decisions regarding cardiopulmonary resuscitation (CPR), rapid response calls (RRCs), and other specific interventions. The aim of this study was to examine the resuscitation plan completion rate among all medical oncology inpatients after the introduction of a 100% completion target. We concurrently examined the outcomes of medical oncology inpatients subject to a RRC to investigate medium- and long-term patient outcomes.
Methods: A prospective real-time longitudinal audit of resuscitation plan completion was conducted of all medical oncology admissions over 3 months. Completion of a resuscitation form at any time, and within 72 h, was recorded. RRC information was obtained from the preceding 6 months. RRC data included event time and trigger, patient tumor type and treatment intent, available resuscitation plan at RRC, patient disposition after RRC, survival to discharge, and to future cancer treatment.
Results: Of 326 hospitalizations, 60% included a completed resuscitation form and 56% within 72 h. There were 53 RRCs in 39 individual patients. Most RRCs were after hours (64%) and without an available resuscitation plan (92%). Additionally, 91% of RRCs were in patients receiving palliative cancer treatment; 53% did not survive to discharge, and 76% received no further systemic cancer treatment.
Conclusion: Resuscitation plan completion remains significantly below the aspirational 100% and requires targeted implementation strategies. A proportion of oncology patients receiving palliative cancer treatment continue to be managed in hospital without a resuscitation plan and undergo RRCs despite a poor prognosis.
Walker AM, Sullivan DR, Holland AE, Nguyen P, Yeo S, Pascoe A, et al.
Introduction: Despite increasing trials examining palliative care for people with thoracic cancer, implementation remains limited. Understanding the core elements of palliative care interventions is critical to improving design, scalability, and accessibility globally. This review aimed to determine the core elements and efficacy of palliative care interventions in thoracic cancer.
Methods: Five medical databases were searched from January 1987 to January 2025. Randomised controlled trials (RCTs) and nonrandomised studies of palliative care interventions in thoracic cancer addressing at least two National Consensus Project domains were eligible. Meta-analyses of RCTs were performed using a random-effects model.
Results: 34 palliative care interventions (n=6490, mean±sd age 65±10 years, 41% women) were identified. Interventions were categorised as comprehensive palliative care interventions (n=18), nonpharmacological symptom interventions (n=12) and psychosocial-educational interventions (n=4). Comprehensive interventions were significantly longer (21.7 weeks) than nonpharmacological symptom (4.8 weeks) and psychosocial-educational interventions (8.7 weeks; p<0.01), addressed more components (mean components: 8, 3, 4, respectively; p<0.01), were often provided by specialist palliative care clinicians (83%, 16%, 0%; p<0.01), and included interprofessional teams (61%, 8%, 0%; p<0.01). Comprehensive palliative care interventions improved quality of life (standardised mean difference (SMD) 0.25, 95% CI 0.11-0.38), survival (hazard ratio 0.76, 95% CI 0.62-0.94), overall symptoms (SMD 0.20, 95% CI 0.02-0.38) and depression (SMD 0.28, 95% CI 0.07-0.5). Nonpharmacological symptom interventions improved breathlessness (SMD 0.29, 95% CI 0.15-0.43) and depression (SMD 0.17, 95% CI 0.02-0.31). Psychosocial-educational interventions did not affect quality of life or mood.
Conclusions: Comprehensive palliative care interventions improved quality of life, survival and symptoms among people with thoracic cancers. Nonpharmacological symptom interventions improved breathlessness and depression.
Last updated 30 April 2024