Challenges of palliative care: A systematic review

Palliative care plays an essential role in improving the quality of life of patients suffering from chronic and incurable diseases; therefore, it seems necessary to remove barriers in improving palliative care. The present systematic review aims to describe the current status of palliative care, and determine the challenges of palliative care services.

In this systematic review study, we searched Scopus, Magiran,SID,Cochran,Embase, PubMed, Web of Science, and Google Scholar databases. Also, we retrieved articles published in English and Persian during 2000 to 2021. The keywords include "hospice care," palliative care," "health care," "terminal care," "end of life care," and palliative medicine". All retrieved articles were screened in three stages, namely review of titles, abstracts, and full texts. Meanwhile, we analyzed data based on the WHO 2018 framework and deductive-inductive approach.

A total of 3497 articles were found. After reviewing these articles, we were able to selecte 48 articles. Data were extracted and categorized according to four functions, namely service delivery, stewardship, resources generation, and financing. Service delivery had four themes, and nine sub-themes; stewardship had two themes and five sub-themes; resource generation had three themes and nine sub-themes; and financing had one themes and three sub-themes.

Findings of the present study can help policymakers improve the infrastructure and resources, as well as processes of palliative care that can consequently lead to an improvement in the outcomes of palliative care. Also, solving the challenges of palliative care requires strengthening the health systems so that they will be able to design and implement appropriate policies