The model and elements of palliative care for patients with terminal illness: A systematic review

Nita Arisanti(1*), Panji F Hadisoemarto(2), Elsa Pudji Setiawati Sasongko(3), Veranita Pandia(4), Dany Hilmanto(5)

(1) Department of Public Health Faculty of Medicine Universitas Padjadjaran
(2) Department of Public Health Faculty of Medicine Universitas Padjadjaran
(3) Department of Public Health Faculty of Medicine Universitas Padjadjaran
(4) Department of Psychiatric Faculty of Medicine Universitas Padjadjaran
(5) Department of Child Health Faculty of Medicine Universitas Padjadjaran
(*) Corresponding Author


Backgorund: Many models of palliative care have already been implemented, however, a model of health care cannot be directly applied in a country because of the differences in socio-cultural, disease patterns and health systems within the country. This study aimed to conduct a systematic review to analyze models of palliative care and elements of model for palliative care. 

Methods: A systematic review was conducted. Articles were searched by four electronic databases; PubMed, Web of Science, Ovid and NICE Database. Three reviewers screened the search results and data were classified according to their main objective. Further synthesize was conducted to show element and model of care. 

Results: The initial search strategy identified 218. Based on Hawker quality assessment scale, only 14 articles met criteria for review and synthesis. Out of 14, 4 articles describe palliative care for chronic disease (heart failure, end stage renal disease) and 10 for cancer. The integrated palliative care model has been the most frequently described. The other models are respite care, care-aide and personal alarm model, family centered advanced care, and end of life care for young adults. This systematic review also identified elements of model for palliative care and categorized as element from patient and family, personnel and health care system.

Conclusion: A few studies are describing a model of palliative care and elements of model for palliative care in detail. More detailed methodological and population specifications are needed to accurately find the results. 


end-of-life care; integrated palliative care model; model of care; quality of life

Full Text:



Tuggey EM, Lewin WH. A multidisciplinary approach in providing transitional care for patients with advanced cancer. Ann Palliat Med. 2014;3(3):139–43.

Kaye EC, Rubenstein J, Levine D, Baker JN, Dabbs D, Friebert SE. Pediatric palliative care in the community. CA Cancer J Clin. 2015;65(4):315–33.

Oishi A, Murtagh FE. The challenges of uncertainty and interprofessional collaboration in palliative care for non-cancer patients in the community: A systematic review of views from patients, carers and health-care professionals. Palliat Med. 2014;28(9):1081–98.

Jagt – van Kampen CT, Kars MC, Colenbrander DA, Bosman DK, Grootenhuis MA, Caron HN, et al. A prospective study on the characteristics and subjects of pediatric palliative care case management provided by a hospital based palliative care team. BMC Palliat Care. 2017;16(1):1–10.

Brinkman-Stoppelenburg A, Boddaert M, Douma J, van der Heide A. Palliative care in Dutch hospitals: a rapid increase in the number of expert teams, a limited number of referrals. BMC Health Serv Res. 2016;16(518):1–7.

Siouta N, Van Beek K, van der Eerden ME, Preston N, Hasselaar JG, Hughes S, et al. Integrated palliative care in Europe: a qualitative systematic literature review of empirically-tested models in cancer and chronic disease. BMC Palliat Care. 2016;15(56):1–16.

Mitchell GK. Palliative care in Australia. Ochsner J. 2011;11(4):334–7.

Kementerian Repubik Indonesia. Keputusan Menteri Kesehatan No. 812 Tahun 2007 tentang Kebijakan Perawatan Paliatif. 2007.

Kristanti MS, Setiyarini S, Effendy C. Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training. BMC Palliat Care. 2017;16(4):1–7.

Rochmawati E, Wiechula R, Cameron K. Current status of palliative care services in Indonesia: a literature review. Int Nurs Rev. 2016 Jun;63(2):180–90.

Putranto R, Mudjaddid E, Shatri H, Adli M, Martina D. Development and challenges of palliative care in Indonesia: Role of psychosomatic medicine. Biopsychosoc Med. 2017;11(1):1–5.

Luckett T, Phillips J, Agar M, Virdun C, Green A, Davidson PM. Elements of effective palliative care models: a rapid review. BMC Health Serv Res. 2014;14(136):1–22.

Hawker S, Payne S, Kerr C, Hardey M, Powell J. Appraising the evidence: reviewing disparate data systematically. Qual Heal Res. 2002;12(9):1284–99.

Carey TA, Schouten K, Wakerman J, Humphreys JS, Miegel F, Murphy S, et al. Improving the quality of life of palliative and chronic disease patients and carers in remote Australia with the establishment of a day respite facility. BMC Palliat Care. 2016;15(62):1–10.

Kamal AH, Bull J, Stinson CS, Blue DL, Abernethy AP. Conformance with supportive care quality measures is associated with better quality of life in patients with cancer receiving palliative care. J Oncol Pract. 2013;9(3):e73-6.

Levine DR, Johnson L-M, Snyder A, Wiser RK, Gibson D, Kane JR, et al. Integrating palliative care in pediatric oncology: an evolving paradigm for comprehensive cancer care. J Natl Compr Canc. 2016;14(6):741–8.

Rugno FC, Paiva BSR, Paiva CE. Early integration of palliative care facilitates the discontinuation of anticancer treatment in women with advanced breast or gynecologic cancers. Gynecol Oncol. 2014;135(2):249–54.

Seow H, Barbera L, Howell D, Dy SM. Using more end-of-life homecare services is associated with using fewer acute care services. Med Care. 2010;48(2):118–24.

Brännström M, Boman K. A new model for integrated heart failure and palliative advanced homecare − rationale and design of a prospective randomized study. Eur J Cardiovasc Nurs. 2013;12(3):269–75.

Aoun S, O’Connor M, Skett K, Deas K, Smith J. Do models of care designed for terminally ill “home alone” people improve their end-of-life experience? A patient perspective. Heal Soc Care Community. 2012;20(6):599–606.

Mack JW, Chen LH, Cannavale K, Sattayapiwat O, Cooper RM, Chao CR. End-of-life care intensity among adolescent and young adult cancer patients in Kaiser Permanente Southern California. JAMA Oncol. 2015;1(5):592–600.

Sattoe JN, Jedeloo S, van Staa A. Effective peer-to-peer support for young people with end-stage renal disease: a mixed methods evaluation of Camp COOL. BMC Nephrol. 2013;14(279):1–14.

Lyon ME, Jacobs S, Briggs L, Cheng YI, Wang J. Family-centered advance care planning for teens with cancer. JAMA Pediatr. 2013;167(5):460–7.

Le BHC, Mileshkin L, Doan K, Saward D, Spruyt O, Yoong J, et al. Acceptability of early integration of palliative care in patients with incurable lung cancer. J Palliat Med. 2014;17(5):553–8.

Borneman T, Koczywas M, Cristea M, Reckamp K, Sun V, Ferrell B. An interdisciplinary care approach for integration of palliative care in lung cancer. Clin Lung Cancer. 2008;9(6):352–60.

Back AL, Park ER, Greer JA, Jackson VA, Jacobsen JC, Gallagher ER, et al. Clinician roles in early integrated palliative care for patients with advanced cancer: a qualitative study. J Palliat Med. 2014;17(11):1244–8.

Bailey C, Murphy R, Porock D. Trajectories of end-of-life care in the emergency department. Ann Emerg Med. 2011;57(4):362–9.

Minkman MMN, Ahaus KTB, Huijsman R. A four phase development model for integrated care services in the Netherlands. BMC Health Serv Res. 2009;9(42):1–11.

Groh G, Feddersen B, Führer M, Borasio GD. Specialized home palliative care for adults and children: differences and similarities. J Palliat Med. 2014;17(7):803–10.

Walter JK, DeCamp LR, Warrier KS, Murphy TP, Keefer PM. Care of the complex chronically ill child by generalist pediatricians: Lessons learned from pediatric palliative care. Hosp Pediatr. 2013;3(2):129–38.

Richardson P. Spirituality, religion and palliative care. Ann Palliat Med. 2014;3(3):150–9.

Bone AE, Morgan M, Maddocks M, Sleeman KE, Wright J, Taherzadeh S, et al. Developing a model of short-term integrated palliative and supportive care for frail older people in community settings: perspectives of older people, carers and other key stakeholders. Age Ageing. 2016;45(6):863–73.

Baker JN, Hinds PS, Spunt SL, Barfield C, Allen C, Powell BC, et al. Integration of Palliative care principles into the ongoing care of children with cancer: Individualized care planning and coordination. Pediatr Clin North Am. 2008;55(1):142–56.

Weaver M, Heinze K, Bell C, Wiener L, Garee AM, Kelly KP, et al. Establishing psychosocial palliative care standards for children and adolescents with cancer and their families: An integrative review. Palliat Med. 2016;30(3):212–23.

Kim S-N, Choi S-O, Shin SH, Ryu J-S, Baik J-W. Development of a community-based palliative care model for advance cancer patients in public health centers in Busan, Korea. Cancer Res Treat. 2016;49(3):559–68.


Article Metrics

Abstract views : 3089 | views : 3228


  • There are currently no refbacks.

Copyright (c) 2019 Nita Arisanti

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.