The experiences of, and need for, palliative care for people with motor neurone disease and their informal caregivers: A qualitative systematic review.

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Title: The experiences of, and need for, palliative care for people with motor neurone disease and their informal caregivers: A qualitative systematic review.
Authors: Flemming, Kate, Turner, Victoria, Bolsher, Samantha, Hulme, Bill, McHugh, Elizabeth, Watt, Ian
Source: Palliative Medicine. Jun2020, Vol. 34 Issue 6, p708-730. 23p. 3 Diagrams, 3 Charts.
Subjects: Amyotrophic lateral sclerosis treatment, Bereavement, CINAHL database, Decision making, Psychology information storage & retrieval systems, Medical needs assessment, MEDLINE, Motor neuron diseases, Palliative treatment, Systematic reviews, Caregiver attitudes, Patients' attitudes
Abstract: Background: Despite being a terminal neurodegenerative disease, the role of palliative care is less recognised for motor neurone disease than for other life-limiting conditions. Understanding the experiences of, and need for, palliative care for patients and carers is key to configuring optimal policy and healthcare services. Aim: To explore the experiences of, and need for, palliative care of people with motor neurone disease and their informal carers across the disease trajectory. Design: A systematic review of qualitative research conducted using Thematic Synthesis – PROSPERO registration CRD42017075311. Data Sources: Four electronic databases were searched (MEDLINE, CINAHL, PsycINFO, Social Science Citation Index) using terms for motor neurone disease, amyotrophic lateral sclerosis, palliative care, and qualitative research, from inception to November 2018. Included papers were data extracted and assessed for quality. Results: A total of 41 papers were included, representing the experiences of 358 people with motor neurone disease and 369 caregivers. Analytical themes were developed detailing patients' and carers' experiences of living with motor neurone disease and of palliative care through its trajectory including response to diagnosis, maintaining control, decision-making during deterioration, engaging with professionals, planning for end-of-life care, bereavement. Conclusion: The review identified a considerable literature exploring the care needs of people with motor neurone disease and their carers; however, descriptions of palliative care were associated with the last days of life. Across the disease trajectory, clear points were identified where palliative care input could enhance patient and carer experience of the disease, particularly at times of significant physical change. [ABSTRACT FROM AUTHOR]
Copyright of Palliative Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: The experiences of, and need for, palliative care for people with motor neurone disease and their informal caregivers: A qualitative systematic review.
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  Data: <searchLink fieldCode="DE" term="%22Amyotrophic+lateral+sclerosis+treatment%22">Amyotrophic lateral sclerosis treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Bereavement%22">Bereavement</searchLink><br /><searchLink fieldCode="DE" term="%22CINAHL+database%22">CINAHL database</searchLink><br /><searchLink fieldCode="DE" term="%22Decision+making%22">Decision making</searchLink><br /><searchLink fieldCode="DE" term="%22Psychology+information+storage+%26+retrieval+systems%22">Psychology information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+needs+assessment%22">Medical needs assessment</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+neuron+diseases%22">Motor neuron diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Palliative+treatment%22">Palliative treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22Caregiver+attitudes%22">Caregiver attitudes</searchLink><br /><searchLink fieldCode="DE" term="%22Patients'+attitudes%22">Patients' attitudes</searchLink>
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  Data: Background: Despite being a terminal neurodegenerative disease, the role of palliative care is less recognised for motor neurone disease than for other life-limiting conditions. Understanding the experiences of, and need for, palliative care for patients and carers is key to configuring optimal policy and healthcare services. Aim: To explore the experiences of, and need for, palliative care of people with motor neurone disease and their informal carers across the disease trajectory. Design: A systematic review of qualitative research conducted using Thematic Synthesis – PROSPERO registration CRD42017075311. Data Sources: Four electronic databases were searched (MEDLINE, CINAHL, PsycINFO, Social Science Citation Index) using terms for motor neurone disease, amyotrophic lateral sclerosis, palliative care, and qualitative research, from inception to November 2018. Included papers were data extracted and assessed for quality. Results: A total of 41 papers were included, representing the experiences of 358 people with motor neurone disease and 369 caregivers. Analytical themes were developed detailing patients' and carers' experiences of living with motor neurone disease and of palliative care through its trajectory including response to diagnosis, maintaining control, decision-making during deterioration, engaging with professionals, planning for end-of-life care, bereavement. Conclusion: The review identified a considerable literature exploring the care needs of people with motor neurone disease and their carers; however, descriptions of palliative care were associated with the last days of life. Across the disease trajectory, clear points were identified where palliative care input could enhance patient and carer experience of the disease, particularly at times of significant physical change. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Palliative Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1177/0269216320908775
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        Text: English
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      – SubjectFull: Amyotrophic lateral sclerosis treatment
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      – SubjectFull: Bereavement
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      – SubjectFull: Motor neuron diseases
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      – SubjectFull: Palliative treatment
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      – SubjectFull: Systematic reviews
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      – SubjectFull: Caregiver attitudes
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      – SubjectFull: Patients' attitudes
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      – TitleFull: The experiences of, and need for, palliative care for people with motor neurone disease and their informal caregivers: A qualitative systematic review.
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              Text: Jun2020
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