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Researching palliative care
David Field, David Clark, Jessica Corner and Carol Davis (eds)
ISBN: 0-335-20436-8 2001 198 pp pages Buckingham: Open University Press
Alexandra Clavarino
Centre for Health Promotion and Cancer Prevention Research, School of Population Health, Medical School, University of Queensland, Herston, QLD
This is a timely book given the rapid expansion of the field of palliative care, increased levels of funding available for palliative care research and the subsequent attempts to encourage new and inexperienced researchers into the field. This book forms the third volume in the Facing Death series. It is intended for all those people wishing to undertake research into palliative care but who lack formal training. However, it is not your typical handbook of research methods but rather brings together a range of previously published articles from a wide range of disciplines involved in palliative care. Editorial comment at the beginning of each part guides the reader to key points associated with the articles that then follow.
At the core of palliative care research are the sensitive ethical and emotional issues associated with conducting research with people who are approaching the end of their lives and who are commonly very ill. Palliative care, like all areas of medicine, is influenced by the culture of evidence-based healthcare. The evidence base is (ideally) derived from research.
The book is divided into three sections. Part I looks at key methods for researching palliative care and includes both qualitative and quantitative approaches. There are seven selected topics in this section and these address some central issues. For example, there is a 'how to' paper on doing a systematic review. As well there is a chapter devoted to that perennial concern of sample size and power - an issue of particular importance to studies typified by small non-representative samples. There is also a discussion of the pros and cons of placebo-controlled trials in palliative care.
Part II consists of five articles that provide specific examples of topics and concerns of relevance to clinical research. There are chapters devoted to common symptoms such as fatigue in advanced cancer as well as to a nursing-based intervention for breathlessness in lung cancer patients. Because of high attrition rates associated with much palliative care research this topic also receives coverage. The third part concentrates on commonly overlooked aspects of research: needs assessments, audits and evaluation. The five articles that form this final part look at the different ways in which palliative care researchers have developed and used a range of methods to assess needs and to measure the outcomes of health services.
The book provides a useful resource for both students and teachers involved in palliative care research and education. Its strength lies in the editorial comment and also in the variety of approaches and topics that are presented. It exposes the reader to a variety of methods and approaches to palliative care research that are not commonly found in more traditional methods texts. The broad range of professionals interested in researching different aspects of palliative care will surely welcome this valuable guide.
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