Abstract
Context
Palliative care (PC) research has grown over the last 20 years. Yet, the causal components
and pathways of PC interventions remain unclear.
Objectives
To document the prevalence and application of theoretical frameworks in developing
and testing PC interventions.
Methods
We conducted a secondary analysis of previously published systematic reviews of PC
randomized clinical trials. Trials were evaluated for explicit mention of a theoretical
framework, process or delivery model, or clinical practice guideline that supported
the development of the intervention. We used a structured data extraction form to
document study population, outcomes, and whether and how authors used a theoretical
framework, process/delivery model, or clinical practice guideline. We applied an adapted
coding scheme to evaluate use of theoretical frameworks.
Results
We reviewed 85 PC trials conducted between 1984 and 2021. Thirty-eight percent (n = 32) of trials explicitly mentioned a theoretical framework, process or delivery
model, or clinical practice guideline as a foundation for the intervention design.
Only nine trials included a theoretical framework, while the remaining 23 cited a
process/delivery model or clinical practice guideline.
Conclusion
Most PC trials do not cite a theoretical foundation for their intervention design.
Future work should focus on developing and validating new theoretical frameworks and
modifying existing theories and models to better explain the mechanisms of the variety
of PC interventions.
Key Words
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Article info
Publication history
Published online: October 28, 2021
Accepted:
October 22,
2021
Identification
Copyright
© 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
