Palliative care Among cancer patients Research 2022

PICO question: Among cancer patients, what is the effect of palliative care compared to
conventional care on quality of life?
Database
Palliative care is an important sphere of healthcare that helps individuals to manage
pain symptoms and improve their quality of life while engaging in curative approaches of
treatment. Thereby, it is an interesting area of study among cancer patients to understand the
true effects of this improved approach to treatment. The effects of palliative care on quality of
life can be debated because palliative care is dependent on various factors, as indicated by
Thaniyath (2019). Thereby, it is essential to understand the circumstances in which palliative
care yields positive results and in which it does not. As a result, the current paper is a
description of a search process to identify the most relevant and useful article to help
understand the topic better. The database chosen to guide in the search was Medline because
it yielded more relevant results compared to the other two. Also, it has a friendlier interface
that made it easier to navigate through the site compared to the other two databases.
Search Process
MeSH OFF
The search process occurred in two phases, whereby, in the first phase, the thesaurus
function was not used while in the second phase, the MeSH thesaurus was activated. The
search process was guided by the use of certain keywords which were combined to form a
string in various attempts. The keywords used were: “Quality of life,” “Effect,” “Palliative
care,” “Conventional care,” “Cancer,” and “Health outcomes.” When the thesaurus function
was not activated, various attempts at finding the relevant articles were made using different
search strings. The first search string used was “Effect of palliative care.” The search yielded
three best matches and 4426 results, as indicated in the figure below. The search results were

from a wide spectrum, and it was difficult and tedious perusing through all the searches to
find the relevant articles.
As a result, the length of the string was increased to “Effect of palliative care versus
conventional care.” The search yielded three best matches and 14 results as indicated in the
figure below.
The sequence of search results prompts to predict that addition of more search words would
help to refine the results better. Therefore, in addition to the previous search string, the
keyword “cancer” was added. In the current case, the trend would be to get the most relevant
results from the 14 because an increase in the length of the search string was associated with

a reduction in the number of results. Eventually, the search string was further lengthened to
include all the relevant keywords in “Effect of palliative care versus conventional care on
quality of life in cancer.” The search yielded four results as shown below.
The results were not relevant to the PICO question guiding this paper. The first article was a
systematic review focusing on the effects of palliative care but did not meet the requirements
of my PICO question due to a lack of a comparison intervention, in this case, conventional
treatment. The second article did not distinguish between palliative and conventional care.
The focus was on the different types of radiotherapy that are part of the palliative care
process. The third article focused on dexamethasone as an intervention for pain in
radiotherapy during the administration of palliative radiotherapy. The fourth article was not
relevant for the current topic because it focused on investigating the effects on adjuvant VHF
in recurrent and unresectable rectal cancer. Thereby, none of the articles met the requirements
of the selected PICO question. The search string, in this case, did not perform well as
anticipated because it contained all the important keywords; yet, it yielded very few and
irrelevant results. The presumption had been that relevant articles would be obtained from the
inclusion of all the keywords to increase the search string length, but this was not the case.