Experiences of healthcare professionals providing palliative care in home settings - a scoping review
Abstract Background The growing preference for home-based end-of-life care accords a dignified death for terminally ill patients. However, for healthcare professionals (HCPs) involved, this caregiving approach is embedded with unique psychosocial, practical and emotional stressors. Without sufficien...
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BMC
2025-03-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-025-01728-z |
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| author | Luke Tan Sonia Sheri Yun Yao Goh Raeanne Fong Ranitha Govindasamy Yun Ting Ong Nur Amira Binte Abdul Hamid Tessa Li Xiang Low Lalit Kumar Radha Krishna |
| author_facet | Luke Tan Sonia Sheri Yun Yao Goh Raeanne Fong Ranitha Govindasamy Yun Ting Ong Nur Amira Binte Abdul Hamid Tessa Li Xiang Low Lalit Kumar Radha Krishna |
| author_sort | Luke Tan |
| collection | DOAJ |
| description | Abstract Background The growing preference for home-based end-of-life care accords a dignified death for terminally ill patients. However, for healthcare professionals (HCPs) involved, this caregiving approach is embedded with unique psychosocial, practical and emotional stressors. Without sufficient support, HCPs face higher risks of moral distress, compassion fatigue, vicarious trauma, secondary traumatic stress and burnout—collectively known as the costs of caring—that precipitate depersonalisation and compromised patient care. Despite its far-reaching implications, current understanding of the costs of caring amongst HCPs in home-based settings remains remiss. Thus, we conduct a scoping review to investigate the experiences of HPCs providing home-based palliative care to terminally ill adult oncology patients. Methods Outlined by the Systematic Evidence-Based Approach and PRISMA guidelines, searches for relevant articles published between 1st January 2000 and 1st October 2024 were performed on PubMed, Embase, Scopus, PsycINFO and CINAHL databases. Selected articles underwent concurrent and independent thematic and content analyses. Central themes and categories were extracted and merged, forming key domains that framed the discussion. Results Of 5676 titles and abstracts screened, 543 full-text articles were reviewed. 20 full-text articles were analysed for inclusion. Four key domains emerged: (1) motivations to practice palliative care; (2) impact on personhood of HCPs (3) challenges faced by HCPs; and (4) support systems for HCPs. Conclusion Providing home-based palliative care to adult oncology patients is fulfilling for HCPs—fostering meaningful professional relationships with patients, a more holistic perspective of life and death and a heightened sense of personal accomplishment. However, HCPs may encounter dissonance amidst conflicts between their dominant beliefs and new experiences, leading to burnout, depersonalisation and poor care delivery that are further exacerbated by the costs of caring, if inadequately addressed. Longitudinal and accessible personalised and organisational support is key to sustaining HCPs’ capacity to deliver compassionate and high-quality palliative care. The use of the Ring Theory of Personhood framework in this review provides an avenue for the structuring of such support systems. |
| format | Article |
| id | doaj-art-ff158c64b40343bca34446b07f10025e |
| institution | Kabale University |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-ff158c64b40343bca34446b07f10025e2025-08-20T03:40:46ZengBMCBMC Palliative Care1472-684X2025-03-0124111110.1186/s12904-025-01728-zExperiences of healthcare professionals providing palliative care in home settings - a scoping reviewLuke Tan0Sonia Sheri1Yun Yao Goh2Raeanne Fong3Ranitha Govindasamy4Yun Ting Ong5Nur Amira Binte Abdul Hamid6Tessa Li Xiang Low7Lalit Kumar Radha Krishna8Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower BlockYong Loo Lin School of Medicine, National University of Singapore, NUHS Tower BlockLee Kong Chian School of Medicine, Nanyang Technological UniversityYong Loo Lin School of Medicine, National University of Singapore, NUHS Tower BlockYong Loo Lin School of Medicine, National University of Singapore, NUHS Tower BlockDivision of Cancer Education, National Cancer Centre SingaporeDivision of Cancer Education, National Cancer Centre SingaporeDepartment of Psychological Medicine, Yong Loo Lin School of Medicine, University Medicine Cluster, National University of SingaporeYong Loo Lin School of Medicine, National University of Singapore, NUHS Tower BlockAbstract Background The growing preference for home-based end-of-life care accords a dignified death for terminally ill patients. However, for healthcare professionals (HCPs) involved, this caregiving approach is embedded with unique psychosocial, practical and emotional stressors. Without sufficient support, HCPs face higher risks of moral distress, compassion fatigue, vicarious trauma, secondary traumatic stress and burnout—collectively known as the costs of caring—that precipitate depersonalisation and compromised patient care. Despite its far-reaching implications, current understanding of the costs of caring amongst HCPs in home-based settings remains remiss. Thus, we conduct a scoping review to investigate the experiences of HPCs providing home-based palliative care to terminally ill adult oncology patients. Methods Outlined by the Systematic Evidence-Based Approach and PRISMA guidelines, searches for relevant articles published between 1st January 2000 and 1st October 2024 were performed on PubMed, Embase, Scopus, PsycINFO and CINAHL databases. Selected articles underwent concurrent and independent thematic and content analyses. Central themes and categories were extracted and merged, forming key domains that framed the discussion. Results Of 5676 titles and abstracts screened, 543 full-text articles were reviewed. 20 full-text articles were analysed for inclusion. Four key domains emerged: (1) motivations to practice palliative care; (2) impact on personhood of HCPs (3) challenges faced by HCPs; and (4) support systems for HCPs. Conclusion Providing home-based palliative care to adult oncology patients is fulfilling for HCPs—fostering meaningful professional relationships with patients, a more holistic perspective of life and death and a heightened sense of personal accomplishment. However, HCPs may encounter dissonance amidst conflicts between their dominant beliefs and new experiences, leading to burnout, depersonalisation and poor care delivery that are further exacerbated by the costs of caring, if inadequately addressed. Longitudinal and accessible personalised and organisational support is key to sustaining HCPs’ capacity to deliver compassionate and high-quality palliative care. The use of the Ring Theory of Personhood framework in this review provides an avenue for the structuring of such support systems.https://doi.org/10.1186/s12904-025-01728-zHomecarePalliative careHealthcare professionalsPersonhoodCosts of caringCompassion fatigue |
| spellingShingle | Luke Tan Sonia Sheri Yun Yao Goh Raeanne Fong Ranitha Govindasamy Yun Ting Ong Nur Amira Binte Abdul Hamid Tessa Li Xiang Low Lalit Kumar Radha Krishna Experiences of healthcare professionals providing palliative care in home settings - a scoping review BMC Palliative Care Homecare Palliative care Healthcare professionals Personhood Costs of caring Compassion fatigue |
| title | Experiences of healthcare professionals providing palliative care in home settings - a scoping review |
| title_full | Experiences of healthcare professionals providing palliative care in home settings - a scoping review |
| title_fullStr | Experiences of healthcare professionals providing palliative care in home settings - a scoping review |
| title_full_unstemmed | Experiences of healthcare professionals providing palliative care in home settings - a scoping review |
| title_short | Experiences of healthcare professionals providing palliative care in home settings - a scoping review |
| title_sort | experiences of healthcare professionals providing palliative care in home settings a scoping review |
| topic | Homecare Palliative care Healthcare professionals Personhood Costs of caring Compassion fatigue |
| url | https://doi.org/10.1186/s12904-025-01728-z |
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