Profiles of palliative day care programs in Canada and the United Kingdom: A meta-synthesis

Background: The first palliative day care program (PDCP) marks its 50th anniversary. Aim: This study examined the distinctive features of PDCPs that have endured, as well as the changes they have undergone in the United Kingdom and Canada, to identify avenues for the development of these programs. Methods: Using primary data from two qualitative studies, conducted in the United Kingdom and Canada, a thematic meta-synthesis was carried out using the expansive secondary analysis approach to identify similarities and distinctions between the PDCPs identified in the two original studies. Results: The results were drawn from group and individual interviews with 19 participants in Canada, including 13 professionals and 6 managers across 6 PDCPs, and 35 participants in the United Kingdom, including 16 professionals and 18 managers from 3 PDCPs. The results indicate that the administrative structure of the PDCPs, the adoption of a palliative care philosophy, and the multidisciplinary nature of the professional and volunteer teams are the components of the programs that have endured. However, patient characteristics, care models, and institutionalization are constantly evolving. Conclusions: As PDCPs continuously innovate to adapt to the needs of their patients, the evolution of their components is desirable. However, pressure to demonstrate the relevance of their services to justify financial resources could, while ensuring their sustainability, deprive them of the values and practices that are their most valuable asset and purpose: supporting people living with advanced diseases with palliative care while still remaining in their own homes.