Hospice care delivered at home, in nursing homes and in dedicated hospice facilities: A systematic review of quantitative and qualitative evidence
- PMID: 20846650
- DOI: 10.1016/j.ijnurstu.2010.08.003
Hospice care delivered at home, in nursing homes and in dedicated hospice facilities: A systematic review of quantitative and qualitative evidence
Abstract
Background: Hospice care supports patients and their families physically and emotionally through the dying phase. In many countries a substantial portion of specialised end-of-life care is provided through hospices. Such care has developed outside of general healthcare and is commonly provided in a patient's home or in dedicated facilities. Hospice provision may need to increase in the future due to an ageing population with a greater need for access to end-of-life care.
Objectives: In this systematic review we sought to identify the current evidence on (1) the effectiveness, including cost-effectiveness, of hospices, and hospice care in a patient's home and in nursing homes and (2) the experiences of those who use and of those who provide such services.
Methods: We included quantitative and qualitative studies on hospice care that was provided in a patient's home, nursing home or hospice. We did not include studies on end-of-life care that was provided as part of general healthcare provision, such as by general practitioners in primary care, community nurses or within general hospitals. For quantitative evaluations we included only those that compared hospice care with usual generalist healthcare. The databases CINAHL, MEDLINE, EMBASE, and The Cochrane Library were searched from 2003 to 2009. Evidence was assessed for quality and data extractions double-checked. For quantitative studies we present the outcome data comparing hospice versus usual care. For qualitative evaluations we organise findings thematically.
Findings: Eighteen comparative evaluations and four thematic papers were identified. Quantitative evidence, mostly of limited quality in design, showed that hospice care at home reduced general health care use and increased family and patient satisfaction with care. Main themes in the qualitative literature revealed that home hospice services support families to sustain patient care at home and hospice day care services generate for the patient a renewed sense of meaning and purpose.
Conclusions: Although studies had methodological limitations, in this review we found much evidence to support the benefits of hospice care. There were limited evaluations found on the impact of hospice care on psychological well-being, such as symptoms of depression, and on inpatient hospice care and non-hospital related costs.
Copyright © 2010 Elsevier Ltd. All rights reserved.
Similar articles
-
Home treatment for mental health problems: a systematic review.Health Technol Assess. 2001;5(15):1-139. doi: 10.3310/hta5150. Health Technol Assess. 2001. PMID: 11532236
-
Participation in environmental enhancement and conservation activities for health and well-being in adults: a review of quantitative and qualitative evidence.Cochrane Database Syst Rev. 2016 May 21;2016(5):CD010351. doi: 10.1002/14651858.CD010351.pub2. Cochrane Database Syst Rev. 2016. PMID: 27207731 Free PMC article.
-
Interventions for preventing and reducing the use of physical restraints for older people in all long-term care settings.Cochrane Database Syst Rev. 2023 Jul 28;7(7):CD007546. doi: 10.1002/14651858.CD007546.pub3. Cochrane Database Syst Rev. 2023. PMID: 37500094 Free PMC article.
-
Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19.Cochrane Database Syst Rev. 2022 May 20;5(5):CD013665. doi: 10.1002/14651858.CD013665.pub3. Cochrane Database Syst Rev. 2022. PMID: 35593186 Free PMC article.
-
Interventions for preventing abuse in the elderly.Cochrane Database Syst Rev. 2016 Aug 16;2016(8):CD010321. doi: 10.1002/14651858.CD010321.pub2. Cochrane Database Syst Rev. 2016. PMID: 27528431 Free PMC article.
Cited by
-
What matters most for end-of-life care? Perspectives from community-based palliative care providers and administrators.BMJ Open. 2015 Jun 29;5(6):e007492. doi: 10.1136/bmjopen-2014-007492. BMJ Open. 2015. PMID: 26124510 Free PMC article.
-
Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK.Eur J Cancer Care (Engl). 2015 Mar;24(2):253-66. doi: 10.1111/ecc.12195. Epub 2014 Apr 15. Eur J Cancer Care (Engl). 2015. PMID: 24735122 Free PMC article.
-
Caregiver-Reported Quality Measures and Their Correlates in Home Hospice Care.Palliat Med Rep. 2020 Jul 7;1(1):111-118. doi: 10.1089/pmr.2020.0055. eCollection 2020. Palliat Med Rep. 2020. PMID: 32856023 Free PMC article.
-
Palliative care reduces morbidity and mortality in cancer.Nat Rev Clin Oncol. 2013 Feb;10(2):80-9. doi: 10.1038/nrclinonc.2012.211. Epub 2012 Dec 18. Nat Rev Clin Oncol. 2013. PMID: 23247373 Review.
-
Impact of the Marie Curie Cancer Care Delivering Choice Programme in Somerset and North Somerset on place of death and hospital usage: a retrospective cohort study.BMJ Support Palliat Care. 2015 Mar;5(1):34-9. doi: 10.1136/bmjspcare-2013-000645. Epub 2014 May 16. BMJ Support Palliat Care. 2015. PMID: 24838731 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical