Which public health approach to palliative care? An integrative literature review

Abstract

Background: Public health and palliative care are both broad disciplines with blurred boundaries. There is growing support for an alignment of palliative care to public health. Given the novel nature of this alignment and the ambiguity of the parent definitions, there is an understandable lack of clarity around this merged model. Methods: The aim of this study is to describe the theoretical features of the public health approach to palliative care as articulated in the current research literature. An integrative literature review was conducted using systematic methods to identify qualitative and quantitative studies that expressly support such an approach. Results: The search identified 18 studies. A thematic synthesis of these studies identified three different paradigms of a public health approach to palliative care within the current empirical research. These were defined as a health-promotion approach focussed on empowerment at community level, a World Health Organisation approach which focussed on systems at country level, and a population-based approach which typically viewed palliative care issues from an epidemiological perspective. Conclusion: This review highlights that the public health approach to palliative care is understood in various ways. It is important that future research studies clarify which public health approach they are referring to.