Palliative and end-of-life educational interventions for staff working in long-term care facilities: An integrative review of the literature

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Background: Given the increase in the number of deaths within long‐term care facilities (LTCFs), the need for palliative and end‐of‐life (EOL) care education among such facilities has been increasing. As such, a systematic synthesis of global palliative and EOL care educational approaches and evaluation can aid further educational development.
Objective: To synthesise the current literature on palliative and EOL care educational interventions for staff working in LTCFs and identify barriers to, and facilitators of, intervention implementation.

Methods: The study used an integrative review framework wherein indexed databases, namely, CINAHL, EMBASE, MEDLINE, PsycINFO, Web of Science, Cochrane Library and Japan Medical Abstract Society, were systematically searched for studies published in English and Japanese between 2007 and 2019. Search terms that are related to palliative care, LTCF, and education were combined to increase search sensitivity. The quality of the papers was assessed using Joanna Briggs Institute Critical Appraisal Tools and the Mixed‐Methods Appraisal Tool.

Results: A total of 52 studies were included in the review. Our results suggested that although studies in this area and setting have been evolving, suboptimal developmental research and educational practices, global variability and unstandardised approaches to education and lacking viewpoints from service users have remained. Barriers to intervention implementation were also reported due to the specific characteristics of LTCFs, which include high staff turnover and considerable variation in professional skills and experience.

Conclusions: Given the different LTCF types, systems and policies across each country or region, further research on standardised educational interventions with contextual considerations using large‐scale studies with robust methodology is needed to meet the increasing demand for palliative and EOL care among the global ageing population.
Implications for practice
Palliative and EOL care educational intervention for LTCF staff need to include more consideration of context, organisational culture and the user involvement throughout the process of education and research to enhance the quality of care in this complex setting.
Original languageEnglish
Article numbere12347
Number of pages14
JournalInternational Journal of Older People Nursing
Issue number1
Early online date12 Sept 2020
Publication statusPublished (in print/issue) - 13 Jan 2021

Bibliographical note

Funding Information:
The first author received funding from Ulster University Vice-Chancellor's Research Scholarship. English proof-read and editing were supported by the Enago.

Publisher Copyright:
© 2020 The Authors. International Journal of Older People Nursing published by John Wiley & Sons Ltd

Copyright 2021 Elsevier B.V., All rights reserved.


  • education
  • health personnel
  • integrative review
  • long-term care
  • palliative care
  • residential facilities


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