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J Pain Symptom Manage. 2012 May;43(5):885-901. doi: 10.1016/j.jpainsymman.2011.05.023.

Education in advanced disease.

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Department of Health Sciences, The University of York, Heslington, York, United Kingdom.



In advanced disease, the management of symptoms and lifestyle are essential for the maintenance of patients' quality of life. Appropriate education by health professionals can help patients to better manage their disease. Although the provision of education by health professionals for patients with advanced cancer is reasonably well documented, much less is known about how health professionals facilitate education with patients with other advanced progressive diseases.


The aim of this review was to synthesize qualitative research examining health professionals' knowledge of, attitudes toward, and ability to deliver educational interventions for symptom and disease management to patients with advanced progressive diseases other than cancer.


The synthesis was conducted using meta-ethnography. Systematic searching of five electronic databases (CINAHL, Medline, PsycInfo, Web of Science Social Science Citation Index, and EMBASE) was performed. Included studies were data extracted and assessed for quality.


Systematic searching of four electronic databases identified 911 records; 17 studies met review inclusion criteria and underwent data extraction and quality appraisal. Three key factors were identified that influenced the delivery of education by health professionals to patients with advanced disease: capacity (to educate and aid decision making), context (of educational delivery), and timing (of education).


Health professionals identify and acknowledge a range of factors that influence their ability to deliver education to patients with advanced disease. The types of circumstantial factors identified in this review can influence the successful delivery of educational interventions and need to be considered when such interventions are being developed.

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