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Palliative Medicine, Vol. 20, No. 8, 727-734 (2006)
DOI: 10.1177/0269216306072620

Methodological and structural challenges in palliative care research: how have we fared in the last decades?

Stein Kaasa

Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Norway and Department of Oncology, St Olav University Hospital, Trondheim, stein.kaasa{at}ntnu.no

Marianne Jensen Hjermstad

Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Norway and Department of Oncology, Ulleval University Hospital, Oslo

Jon Ha°vard Loge

Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Norway and Department of Oncology, Ulleval University Hospital, Oslo

The heterogeneity of the palliative care population represents challenges to research methodology, including study design, informed consent (and ethical issues in general), assessment and classification of symptoms and signs, as well as practical issues in the clinic.

The aim of this report is to describe and examine the status of palliative care research in Europe by means of a survey and a literature review.

Only one European country, the UK, has taken a national initiative to stimulate and promote palliative care research through the supportive and palliative care collaboratives (SUPAC) in 2005. There are few European research groups in palliative care reaching a critical size, several countries do not have academic chairs in palliative care, and there is no clear trend that chairs are emerging in general. There is little public funding for palliative care research. Palliative care researchers need to compete on the ‘open market’ or rely on private foundations.

There has been a steady increase in the number of abstracts for presentation at the EAPC Research Forums, from 200 in 2000, to 480 in 2006. The literature review indicated that the majority of publications are surveys and descriptive/observational studies, and few randomised, controlled, studies were published.

In conclusion, the quantity of research seems to be steadily increasing. There may be a need for larger multi-centre studies, and in order to perform such studies, national and international structures, encompassing research above the critical size, with a multi-disciplinary background including both basic scientists and clinicians is required.

Key Words: Palliative care • research • research design • review literature


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