Abstract
Background/aims: Social isolation and loneliness in palliative care can contribute to low mood, pain, and suffering towards the end of life. Hospices in the UK provide a range of day and outpatient services that facilitate social support for patients and caregivers. These interventions aim to reduce unmet social need and improve wellbeing and quality of life; but there is limited understanding of the contexts and mechanisms that lead to outcomes.
We aimed to develop evidence-based explanations of how social support interventions can improve outcomes in palliative care, for whom, and in what circumstances.
Methods: Informed by realist evaluation, qualitative data collection took place in nine independent hospices in England. These were interviews with hospice service-providers (n=19) and researcher observations of day services (n=12). Sampling of research locations was informed by an online survey1. Analysis via context-mechanism-outcome configurations led to the development of an initial programme theory.
Results: Palliative care patients and their caregivers experience loneliness and social isolation due to the losses associated with illness, changing support needs, and contextual constraints on emotional communication. Coming together with others ‘in the same boat’ encourages honesty, reciprocity, and gains in confidence. The holistic safety of the hospice environment thus enables acceptance and adaptation to change.
Conclusions: In some contexts, social support can improve ability to cope with illness and prepare for dying. This could improve quality of life for patients and alleviate burden on caregivers. Ongoing research explores increasing complexity in patient need, and variation in practice since the Covid-19 pandemic.
We aimed to develop evidence-based explanations of how social support interventions can improve outcomes in palliative care, for whom, and in what circumstances.
Methods: Informed by realist evaluation, qualitative data collection took place in nine independent hospices in England. These were interviews with hospice service-providers (n=19) and researcher observations of day services (n=12). Sampling of research locations was informed by an online survey1. Analysis via context-mechanism-outcome configurations led to the development of an initial programme theory.
Results: Palliative care patients and their caregivers experience loneliness and social isolation due to the losses associated with illness, changing support needs, and contextual constraints on emotional communication. Coming together with others ‘in the same boat’ encourages honesty, reciprocity, and gains in confidence. The holistic safety of the hospice environment thus enables acceptance and adaptation to change.
Conclusions: In some contexts, social support can improve ability to cope with illness and prepare for dying. This could improve quality of life for patients and alleviate burden on caregivers. Ongoing research explores increasing complexity in patient need, and variation in practice since the Covid-19 pandemic.
| Original language | English |
|---|---|
| Article number | FC 15.2 |
| Pages (from-to) | 55 |
| Number of pages | 1 |
| Journal | Palliative Medicine |
| Volume | 37 |
| Issue number | 1_suppl |
| Publication status | Published - 07 Jun 2023 |
| Externally published | Yes |