The model and elements of a palliative care plan for patients with terminal illness: A systematic review

Abstract

Background: Palliative care has been a part of the healthcare system in Indonesia since its introduction in 1989; however, few formal institutions provide palliative care. Access to care, inconsistency in the standard of care, conflicting healthcare guidelines, inadequate healthcare funding, sociocultural values, disease patterns, and antiquated health systems within the country all help to contribute to this situation. The aim of this study was to conduct a systematic literature review analyzing models of palliative care and elements of a model for palliative care. Methods: The literature was searched in four electronic databases: Medline, PubMed, Web of Science, and the National Institute for Health and Care Excellence (NICE) Database. Three reviewers screened the search results and the data were classified according to the main objective. Further synthesis was conducted to demonstrate elements for a model of care. Results: The initial search strategy identified 207 articles. Based on the Hawker quality assessment scale, only 14 articles met the criteria for review and synthesis. Of these 14 articles, four described palliative care for chronic diseases (such as heart failure and end-stage renal disease) and 10 for cancer. The integrated palliative care model has been the most frequently described. The other models are respite care, care-aide, the personal alarm model, family-centered advanced care, and end-of-life care for young adults. This systematic review also identified elements for a model of palliative care and categorized them as patient and family, personnel, and healthcare system models. Conclusion: There are various studies describing models and their elements for palliative care. The integrated palliative care model has been the most frequently described.