1. Panate Pukrittayakamee
Palliative Care
Panate Pukrittayakamee

2. Outline Definition of Research methodology in Palliative Care
Academic subjects
Research methodology in Palliative Care
A seminal research article
Evaluation of its contribution

3. Definition Holistic treatment for advanced diseases Academic subjects
Multidisciplinary team approach
To promote quality of life
To support patients during a dying process
Academic subjects
Pain, physical complications
Bereavement and psychological reactions
Social, spiritual aspects, law and ethics
(WHO, 2011; Ferris et al, 2009; Clark, 2009; von Gunten, 2009;
King's College London)

4. Research methods Clinical trial (Bennett, 2007)
Development of new treatment
Survey research (Addington-Hall, 2007)
Using a questionnaire to ask for opinion
Epidemiological research (Costantini and Higginson, 2007)
Prevalence or associated factors of disease
Qualitative research (Payne, 2007)
To explore experiences of patients

5. Research article
Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer
(Temel et al, 2010)
The New England Journal of Medicine

6. Research summary Randomized-Controlled Trial (RCT)
151 Patients were divided into two groups
Early palliative care with standard treatment
Only standard treatment
Outcomes of treatment were measured by
Rating scale for quality of life
Rating scale for depression and anxiety
Survival time

7. Outcome Outcome of early palliative treatment Better quality of life
Lower incidence of depression
Longer survival time

8. Evaluation Reliable Methodology Contribution RCT
Enough sample size and sufficient power
Contribution
Great impact to the trend in clinical practice
Palliative care should be initiated early
Helping patients understand prognosis and plan their lives (Temel et al, 2011)
It should be implemented in outpatient unit

9. Limitation This concept cannot be applied to other advanced diseases
Inadequate supply of palliative care teams (Nieder and Norum, 2012)

10. Conclusion
Palliative care is designed to improve quality of life in advanced diseases
It requires knowledge in medicine, psychiatry and social issue
Both quantitative and qualitative researches can be used
Early palliative care is a research topic that changes attitude of physicians
Early Palliative treatment should be provided early in order to improve quality of life

11. List of References
WHO. (2011). Palliative care for older people: better practices. Copenhagen, WHO Regional Office for Europe.
Ferris, F. et al. (2009). “Palliative Cancer Care a Decade Later: Accomplishments, the Need, Next Steps—From the American Society of Clinical Oncology.” Journal of Clinical Oncology 27(18):
Clark, D. (2009). International progress in creating palliative medicine as a specialized discipline. Oxford Textbook of Palliative Medicine (4 ed.). G. Hanks et al. Oxford University Press.

12. List of References
von Gunten, C., Buckholz, G., Ferris, F. (2009). Education and training in palliative medicine: training specialists in palliative medicine. Oxford Textbook of Palliative Medicine (4 ed.). G. Hanks et al. Oxford University Press.
King’s College London. (2014, 14/07/14). “Palliative Care MSc.” Retrieved 14/07/14, from
Bennett, M. (2007). Principles of designing clinical trials in palliative care. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press:

13. List of References
Addington-Hall, J. (2007). Survey design. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press:
Costantini, M. and Higginson, I. (2007). Experimental and quasi-experimental designs. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press:
Payne, S. (2007). Qualitative methods of data collection and analysis. Research methods in palliative care. J. Addington-Hall et al. New York, Oxford University Press:

14. List of References
Temel, J. et al. (2010). “Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer.” The New England Journal of Medicine 383(8):
Temel, J. et al. (2011). “Longitudinal Perceptions of Prognosis and Goals of Therapy in Patients With Metastatic Non–Small-Cell Lung Cancer: Results of a Randomized Study of Early Palliative Care.” Journal of Clinical Oncology 29(17):
Nieder, C. and Norum J. (2012). “Early palliative care in patients with metastatic non-small cell lung cancer.” Annals of Palliative Medicine 1(1):