The Experience of Care in People With Palliative Needs and Their Families: A Qualitative Metasynthesis
Ana Gil Méndez, Caterina Checa Jiménez, Ingrid Bullich Marín, Laura Navarrete Reyes, Carolina Watson Badia, Nina Granel Gimenez, Lídia Ribera Barberan, Mireia Subirana Casacuberta, Juan M. Leyva‐MoralABSTRACT
Aim
To synthesise and reinterpret qualitative evidence on how people with palliative care needs and their family caregivers experience the care process.
Background
Palliative care aims to provide holistic, person‐ and family‐centred care. Although qualitative research has explored multiple aspects of end‐of‐life care, existing knowledge remains fragmented, limiting its translation into coherent, humanised, and clinically applicable nursing care models.
Design
A qualitative systematic review with interpretive meta‐synthesis.
Methods
A qualitative meta‐synthesis was conducted following PRISMA guidelines. Systematic searches were performed in PubMed, CINAHL, and Scopus for studies published between 2014 and 2024, in English or Spanish, involving adults with palliative care needs and/or their family caregivers from OECD countries. A total of 3232 records were identified. Following screening and full‐text review, 13 qualitative studies were included. Methodological quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Findings were synthesised through an interpretive approach using reflexive thematic analysis.
Results
The care experience is configured as a dynamic, relational, and non‐linear process, characterised by emotional, physical, and social demands. Family caregivers report a substantial caregiving burden, often exacerbated by a lack of support, constrained resources, and communication challenges with healthcare teams. From the perspective of people with palliative care needs, the experience of care is closely linked to respect for autonomy, preservation of identity, and the quality of relational presence. Dignity emerges as a cross‐cutting theme, strengthened or undermined by nursing practices, interpersonal interactions, and organisational contexts.
Conclusion
Effective palliative care requires relational nursing practices that uphold dignity and support the family as a unit of care.
Relevance to Clinical Practice
Nursing practice must systematically integrate relational competencies to preserve patient identity and support the family as a care unit. Bureaucratic healthcare structures often act as active barriers to care, necessitating organisational redesign to support family accompaniment.