Patient, nursing and medical staff experiences and perceptions of the care of people with palliative esophagogastric cancer: a systematic review of the qualitative evidence
Authors: Cowley Alison , Evans Catrin , Bath-Hextall Fiona , Cooper Joanne 
Published: November 2016

EXECUTIVE SUMMARY

Background
Esophagogastric cancer is the fifth most common malignancy and its incidence is increasing. The disease progresses quickly and five-year survival rates are poor. Treatment with palliative intent is provided for the majority of patients but there remains a lack of empirical evidence on the most effective service models to support esophagogastric cancer patients.

Objectives
The overall objective of this systematic review was to synthesize the best available evidence on the experiences and perceptions of patients and health professionals with regard to the care of people diagnosed with palliative esophagogastric cancer.

Inclusion criteria Types of participants
The review considered studies that included patients diagnosed with palliative esophagogastric cancer and any health professionals involved in the delivery of palliative care to this patient group in a hospital, home or community setting.

Phenomena of interest
The review considered studies that investigated the experiences and perceptions of people diagnosed with palliative esophagogastric cancer and staff working with these people.

Context
Studies that were carried out in any setting, including in-patient and outpatient areas, specialist cancer and non-specialist palliative care services and those were any patient were in receipt or had experiences of palliative care services were considered. All types of health practitioners delivering palliative care to esophagogastric cancer patients were considered.

Types of studies
Studies that focused on qualitative data, including, but not limited to, designs such as phenomenology, grounded theory, ethnography, action research, feminist research and narrative approaches were considered. Mixed methods studies were considered in the review only if qualitative findings were reported separately.

Search strategy
A three-step search strategy was utilized. A total 11 databases were searched for studies from 2000 onward, followed by hand searching of reference lists.

Methodological quality
Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument critical appraisal tool (JBI-QARI).

Data extraction
Qualitative findings were extracted using the JBI-QARI data extraction Instrument.

Data synthesis
Qualitative research findings were pooled using a pragmatic meta-aggregative approach.

Results
The review included two publications. There were 46 findings which were aggregated into four categories and one overall synthesized finding: “In addition to support for physical needs, patients need support that takes into account changing life situations to achieve the best quality of life.”

Conclusions
The review shows that patients value services and support that addresses their complex, fluctuating and highly individual needs. No evidence was uncovered regarding how these services should be designed and delivered.