A decade of palliative care needs in humanitarian settings: A systematic scoping review of literature between 2012 and 2022
Michelle McGannan, Victoria Barber-Fleming, David Fearon, Liz GrantAbstract
Objectives
To better understand the palliative care needs of people with serious and/or chronic conditions, and their families, in humanitarian settings in low-and middle-income countries between 2012 and 2022.
Methods
A systematic scoping review methodology was employed to enable a wide-ranging search of this under-researched area. Databases and websites were systematically searched, in addition to correspondence to key experts.
Results
Eighty-eight documents were included, comprising 63 publications in peer-reviewed journals, 5 conference abstracts, 4 conference posters, 7 case reports, 5 reports, 2 research snapshots, 1 survey report, and 1 master’s thesis. The majority of literature was from the Public Health Emergency setting including 42 documents related to COVID and 30 to Ebola. Significantly less literature was identified from other settings: refugee populations ( n = 10), multiple settings ( n = 3), natural disaster contexts ( n = 2), and conflict settings ( n = 1). Sixty-four documents considered patient needs, 17 considered combined patient/family needs and 7 focused on family needs. Forty-six documents focused on adults, 25 on adults/children, 6 on children with 11 having no age specification. Findings from individual humanitarian contexts were mapped to palliative care domains and themes presented narratively.
Significance of results
The literature from Public Health Emergencies (Ebola and COVID) overshadowed other humanitarian contexts, demonstrating the comparative paucity of research in refugee, natural disaster, and conflict settings. The voice of children appeared under-represented, as did the perspective of family/caregivers. While there was strong research on pain and physical symptoms, holistic needs were also identified, highlighting the diversity of palliative care needs in humanitarian settings.