Combined rehabilitation and palliative care interventions for patients with life-threatening diseases – PREGOAL. A scoping review of intervention programme goals

Abstract

Purpose

WHO recommends integrating rehabilitation into palliative care when providing services for people with life-threatening conditions. Recently, there has been increasing interest in exploring how rehabilitation and palliative care approaches could be combined. The aim of this study was to map and discuss the goals of intervention programmes that combine rehabilitation and palliative care.

Methods

A scoping review was performed. The electronic databases MEDLINE, EMBASE, and CINAHL were searched for papers published between January 2014 and September 2022. Papers were considered eligible if the participants in question had a life-threatening disease and if interventions included both rehabilitation and palliative care. All study types were included.

Results

Ten papers describing five interventions were included. Qualitative goals were narratively described, and quantitative goals were analysed according to the International Classification of Functioning, Disability and Health, and the Total Pain framework. Findings showed an overall focus on functioning and quality of life. Further analysis indicated an emphasis on physical and psychological dimensions. Social participation, and the social and spiritual dimensions were rarely evaluated.

Conclusion

This review indicates that goals relative to social participation, the social and spiritual dimensions, and the patient’s own goals may well be overlooked as points of orientation for interventions.

IMPLICATIONS FOR REHABILITATION

• There is an increasing interest in combining palliative care and rehabilitation approaches in clinical work.

• When rehabilitation and palliative care are combined, goals may be overlooked, and the patient’s own goals can be used as a point of orientation for interventions.

• Future practice should pay special attention to subjective goals, social participation, and the social and spiritual dimensions when combining rehabilitation and palliative care.

Keywords:

• Palliative care
• rehabilitation
• goals
• life-threatening disease
• ICF
• total pain

Acknowledgements

We would like to thank research assistant Navina Uthayakumaran for her help in the second phase of the screening and research assistant Fie Holm Grünfeld for her help in processing the manuscript for submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This scoping review was partly funded by REHPA, the Danish Knowledge Centre for Rehabilitation and Palliative Care.