The Impact of COVID-19 Pandemic on Palliative Care Services as Perceived by Healthcare Professionals: A Systematic Review

ABSTRACT

Background: The Covid-19 pandemic stretched healthcare systems' capacity, imposed the reorganization and reprioritization of services under the burden of scarce resources, and altered the traditional way that care was provided. Palliative care, though designed to address complex needs such as relief from severe suffering, difficult decision making and complicated grief was not an exception;its holistic approach of care was seriously challenged due to infection spread restrictions. Objective: To review the impact on palliative care services from healthcare professionals' perspective. Methodology: A systematic review according to the Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) was conducted via PubMed in October 2022. Eligibility criteria included original studies that had used a qualitative, quantitative, or mixed design approach to evaluate the impact on services, delivery of care, and emotional status of palliative healthcare professionals. Results: Out of 2040 initial records, 32 studies were included in the review coming from various countries and settings with representative participation of multidisciplinary palliative care teams' members. Reported impacts concerned organizational aspects and provision of services, altered delivery of care, and implications for the mental health of involved staff. Increased workload, visiting restrictions, use of Personal Protective Equipment, and remote contact were perceived as factors compromising the quality of care provided and impeding palliative healthcare professionals from fulfilling their holistic care role. Moral distress was the most exacerbated emotional impact. Conclusions: Despite the important role that palliative care can play during a health crisis, this was not always adequately reflected on pandemic plans. In the era of the Covid-19, Palliative care entered a phase of change;whether this fact may compromise or accelerate its evolvement depends on how lessons learned will be used in future planning.