Abstract

This research seeks to characterize the bibliometric indicators regarding cancer patients’s knowledge about palliative care. Bibliographic search associating the descriptors “ patient, ” “ palliative care, ” “ knowledge ” and “ neoplasm ” found low publication ratio and limited conexion among authors. Asian countries account for most publications, but the level of knowledge on the topic was limited given its strong association with end-of-life care aimed at hospitalized cancer patients without possibility of cure. Mapping the main bibliometric indicators on knowledge about palliative care pointed out the need for further publications on the topic to provide better understanding.

Palliative care; Knowledge; Elderly; Neoplasms

Resumo

Esta pesquisa busca caracterizar os indicadores bibliométricos acerca do conhecimento de pacientes com câncer sobre cuidados paliativos. Por meio da associação dos descritores “ patient ”, “ palliative care ”, “ knowledge ” e “ neoplasm ” encontrou-se baixa taxa de publicação, com tendência a elevação, além de rede de conexão limitada entre os autores. Os países asiáticos foram os que mais publicaram, mas observou-se nível de conhecimento limitado sobre o tema, pois há forte associação com cuidados de fim de vida, destinados apenas a pacientes com câncer, internados em hospital e sem cura. Este estudo permitiu mapear os principais indicadores bibliométricos a respeito do conhecimento de pacientes com câncer sobre os cuidados paliativos, sendo perceptível o crescimento de publicações sobre o tema, mas ainda com baixa quantidade total. Evidencia-se, assim, a necessidade de mais publicações para a obtenção de maior entendimento sobre o tema.

Cuidados paliativos; Conhecimento; Idoso; Neoplasias.

Resumen

Este estudio tiene como objetivo caracterizar los indicadores bibliométricos de conocimiento de los pacientes con cáncer sobre cuidados paliativos. A partir de la asociación entre las palabras clave “ patient ”, “ palliative care ”, “ knowledge ” y “ neoplasm ”, se constató una baja tasa de publicación, con tendencia al alza, así como una limitada red de conexiones entre autores. Los países asiáticos fueron los que más publicaron, aunque el nivel de conocimientos sobre el tema era limitado, ya que lo asocian a los cuidados al final de la vida, destinados únicamente a los pacientes oncológicos, hospitalizados y no curados. Este estudio permitió trazar los principales indicadores bibliométricos sobre el conocimiento de los cuidados paliativos por parte de los pacientes con cáncer, y se observó que hubo un aumento de las publicaciones sobre el tema, aunque el número total sigue siendo bajo. Esto pone de manifiesto la necesidad de más publicaciones para conocer mejor el tema.

Cuidados paliativos; Conocimiento; Anciano; Neoplasias

A process of demographic transition is underway throughout the world. In developing countries, this is occurring at an accelerated rate, causing an increase in life expectancy. It is estimated that older adults will account for 33% of the Brazilian population in 2060, up from 7.6% in 2020 ¹1. Mendonça JMB, Abigalil APC, Pereira PAP, Yuste A, Ribeiro JHS. O sentido do envelhecer para o idoso dependente. Ciênc Saúde Colet [Internet]. 2021 [acesso 21 ago 2023];26(1):57-65. DOI: 10.1590/1413-81232020261.32382020
https://doi.org/10.1590/1413-81232020261...

2. Souza EM, Silva DPP, Barros AS. Educação popular, promoção da saúde e envelhecimento ativo: uma revisão bibliográfica integrativa. Ciênc Saúde Colet [Internet]. 2021 [acesso 21 ago 2023];26(4):1355-68. DOI: 10.1590/1413-81232021264.09642019
https://doi.org/10.1590/1413-81232021264... - ³3. Torres KRBO, Campos MR, Luiza VL, Caldas CP. Evolução das políticas públicas para a saúde do idoso no contexto do Sistema Único de Saúde. Physis (Rio J.) [Internet]. 2020 [acesso 21 ago 2023];30(1):e300113. DOI: 10.1590/S0103-73312020300113
https://doi.org/10.1590/S0103-7331202030... . Aging is influenced by several factors and characterized by a greater susceptibility to chronic diseases, including cancer ⁴4. Wingerter DG, Braga BF, Santos CDP, Silva DN Jr, Brito EWG, Lyra CO et al. A pessoa idosa na Atenção Primária à Saúde: um estudo bibliométrico da produção científica internacional. Rev Bras Med Fam Comunidade [Internet]. 2021 [acesso 21 ago 2023];16(43):2452. DOI: 10.5712/rbmfc16(43)2452
https://doi.org/10.5712/rbmfc16(43)2452... , whose number of cases is expected to double between 2015 and 2035 ⁵5. Soto-Perez-de-Celis E, Cordoba R, Gironés R, Karnakis T, Paredero I, Chavarri-Guerra Y et al. Cancer and aging in Ibero-America. Clin Transl Oncol [Internet]. 2018 [acesso 21 ago 2023];20(9):1117-26. DOI: 10.1007/s12094-018-1844-1
https://doi.org/10.1007/s12094-018-1844-... .

Patients with cancer and their families undergo intense suffering, not only in physical terms but also in social loss and psychological and spiritual suffering, especially when the disease is advanced ⁶6. Estapé T. Cancer in the elderly: challenges and barriers. Asia Pac J Oncol Nurs [Internet]. 2018 [acesso 21 ago 2023];5(1):40-2. DOI: 10.4103/apjon.apjon_52_17
https://doi.org/10.4103/apjon.apjon_52_1... . One of the strategies validated and recommended by guidelines is to associate palliative care with the regular care of cancer patients, especially when the disease is in an advanced stage, alongside curative or disease-modifying therapy ⁷7. Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al. Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol [Internet]. 2017 [acesso 21 ago 2023];35(1):96-112. DOI: 10.1200/JCO.2016.70.1474
https://doi.org/10.1200/JCO.2016.70.1474... .

The discussion about palliative care as a practice that changes patients’ reality, bringing benefits to them and their families, has been ongoing since the 1960s, with the modern hospice movement. Palliative care is provided by a specialized multidisciplinary team, in tandem with standard treatment, providing patients with comprehensive support. Such care goes beyond treating the disease, supporting patients and family members in their physical, psychological, social and spiritual needs, in addition to providing care planning focused on reducing symptoms and increasing the quality of life ⁷7. Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM et al. Integration of palliative care into standard oncology care: American Society of Clinical Oncology Clinical Practice Guideline update. J Clin Oncol [Internet]. 2017 [acesso 21 ago 2023];35(1):96-112. DOI: 10.1200/JCO.2016.70.1474
https://doi.org/10.1200/JCO.2016.70.1474... , ⁸8. Pinto KDC, Cavalcanti AN, Maia EMC. Principles, challenges and perspectives of palliative care in the context of the multiprofessional team: literature review. Psicol Conoc Soc [Internet]. 2020 [acesso 21 ago 2023];10(3):226-57. DOI: 10.26864/PCS.v10.n3.10
https://doi.org/10.26864/PCS.v10.n3.10... .

Despite the proven benefits, the implementation of palliative care faces several barriers. Since 2014, the Worldwide Hospice Palliative Care Alliance has highlighted the importance of spreading knowledge of this specialty among healthcare providers, patients and families, ⁹9. Worldwide Palliative Care Alliance. Global atlas of palliative care [Internet]. 2 a ed. London: World Health Organization; 2020 [acesso 21 ago 2023]. Disponível: https://bit.ly/3N803YR
https://bit.ly/3N803YR... since poor or mistaken knowledge may hinder the implementation of this type of care ¹⁰10. Bennardi M, Diviani N, Gamondi C, Stüssi G, Saletti P, Cinesi I, Rubinelli S. Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families. BMC Palliat Care [Internet]. 2020 [acesso 21 ago 2023];19(1):47. DOI: 10.1186/s12904-020-00556-7
https://doi.org/10.1186/s12904-020-00556... .

In recent decades, the number of publications on palliative care has increased, which shows its importance and the growing interest of researchers on the topic. The studies are mainly dedicated to evaluating the knowledge of caregivers and healthcare providers about palliative care in the oncology area. However, few studies address the knowledge of cancer patients on the topic ¹¹11. Andrade CG, Costa ICP, Freire MEM, Dias TKC, França JRFS, Costa SFG. Scientific production about palliative care and communication in online journals: a scoping review. Rev Bras Enferm [Internet]. 2021 [acesso 21 ago 2023];74(2):e20190378. DOI: 10.1590/0034-7167-2019-0378
https://doi.org/10.1590/0034-7167-2019-0... .

In view of the above, this study proposed the following guiding question: What are the bibliometric indicators of scientific production available in online journals regarding the knowledge of cancer patients about palliative care? In order to answer it, the study aims to characterize such indicators.

Method

This is a bibliometric study, a method that makes it possible to map the literature in an objective manner by using bibliometric indicators in order to answer questions about the impact of research on society and measure the patterns of scientific production and their trends over time ¹²12. Benton DC, Brenton AS. Focus and trends in nurse advocacy in the Pan American Health region: a bibliometric analysis. Rev Latino-am Enferm [Internet]. 2020 [acesso 21 ago 2023];28. DOI: 10.1590/1518-8345.4368.3312
https://doi.org/10.1590/1518-8345.4368.3... . The productivity of the identified journals is evaluated by using Bradford’s law, a mathematical analysis that makes it possible to group journals into zones, considering individual productivity ¹³13. Lucena PLC, Costa SFG, Batista JBV, Lucena CMF, Morais GSN, Costa BHS. Scientific production on workplace bullying and nursing: a bibliometric study. Rev Esc Enferm USP [Internet]. 2018 [acesso 21 ago 2023];52:e03354. DOI: 10.1590/S1980-220X2017029103354
https://doi.org/10.1590/S1980-220X201702... .

The study began in October 2022, with searches in Scopus and Web of Science, the most comprehensive and multidisciplinary databases used in this type of review, covering literature in the field of biomedical science. Scopus also covers 100% of the MEDLINE database material. The search strategy for this review is based on the association of the descriptors “patient,” “palliative care,” “knowledge” and “neoplasm,” with singular and plural synonyms, to make the search as comprehensive as possible, with the Boolean operator “and.”

Full articles published in online journals about cancer patients’ knowledge regarding palliative care were included in the sample. Newsletters, editorials, brief communications and book chapters were excluded. The search covered all publications available in the databases, regardless of time period or language.

The article screening process was carried out using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) methodology. All the basic information of the collected articles – author, title, abstract, keyword, journal, year of publication, authors’ affiliation, number of citations and impact factor—were downloaded from the Web of Science and Scopus database and organized in an Excel spreadsheet. Duplicate articles were excluded and, after reading and analysis by two independent authors, studies that did not meet the inclusion criteria were excluded.

The data from the included articles were imported into BiblioShiny (bibliometrix package in R 4.2.0) to automatically analyze bibliographic information. The information included global publication trends, global citation trends, country/institution/journal distributions, historical direct citation network, thematic map of author keywords, international collaborations, most cited journals/articles/references locally and most cited articles globally. All figures and tables were exported directly from BiblioShiny.

Bradford’s law was used to evaluate the distribution of articles in scientific journals, making it possible to separate the total number of journals into groups or zones, determined by individual productivity. In the zones are the journals that publish less frequently; in the core those with the highest productivity.

Results

The methodology used for the study found 126 articles on Web of Science (70) and Scopus (56). During the screening and pre-analysis process, 80 were excluded for being duplicates, and following the reading of title, abstract and full text, another 33 articles that did not correspond to the research objective were excluded. Eventually, 13 documents, published between 2012 and 2022, were subjected to analysis.

The first study selected is from 2012 and no publications were identified in the following year. There was an isolated increase in 2018 and an upward trend in 2021 and 2022, with two publications in each year.

Some heterogeneity was observed ( Table 1 ) regarding the number of publications by country of the institutions to which the main authors are affiliated, with Singapore, Australia and South Korea having two publications each. Together, they account for approximately 45% of publications, while the other countries have one publication each. Next are featured data related to the main institutions to which the authors are affiliated, also with a heterogeneous distribution, without major differences. Duke-NUS Medical School and Seoul National University Hospital rank first with two publications each and the other institutions have one publication each.

Table 2 features the most relevant articles and journals, classified by the total number of citations. The top ranked ¹⁴14. Zimmermann C, Swami N, Krzyzanowska M, Leighl N, Rydall A, Rodin G et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ [Internet]. 2016 [acesso 21 ago 2023];188(10):e217-27. DOI: 10.1503/cmaj.151171
https://doi.org/10.1503/cmaj.151171... has 193 citations, almost four times more than the second, ¹⁵15. Collins A, McLachlan S-A, Philip J. Initial perceptions of palliative care: an exploratory qualitative study of patients with advanced cancer and their family caregivers. Palliat Med [Internet]. 2017 [acesso 21 de ago 2023];31(9):825-32. DOI: 10.1177/0269216317696420
https://doi.org/10.1177/0269216317696420... even though it was published in the Canadian Medical Association Journal , which is located in zone 3 of the Bradford distribution, with an impact factor of 16.9. The subsequent three articles in the top ten globally cited list were published in higher impact factor journals, located in Bradford zone 1. The journal with the best position in the Bradford zones ( Journal of Symptom and Pain Management ), with a very high impact factor (5.575), did not have any articles among the most cited, possibly because they were published more recently (2021 and 2022).

When analyzing the journals according to Bradford’s law ( Table 3 ), the Journal of Pain and Symptom Management appears in zone 1, the most central, followed by Palliative Medicine and Supportive Care in Cancer , all with a high impact factor. Cancer Medicine and BMC Palliative Care —zones 3 and 2, respectively—have few individual publications, despite the high impact factor in the production of this specific subject.

In the study proposed, the selected articles were identified by using common keywords specified by the authors to summarize the focus of their work. Thus, when analyzing the occurrence of these keywords in a word cloud, the terms “cancer” and “patient” stand out. The most frequent words in the abstracts were also evaluated, with “care,” “patient,” “palliative” and “cancer” being the most repeated.

The study population consisted of adult cancer patients, and five of the articles also evaluated family members and/or caregivers. Regarding methodology, two studies are qualitative (15.3%) and used semi-structured interviews to collect empirical material, two studies (15.3%) used mixed approaches and the others (69.2%) adopted a quantitative approach. Only two articles used a questionnaire previously validated in the literature; the others administered non-validated questionnaires, mostly designed by the actual author, or semi-structured interviews.

Discussion

A small number of articles were found in the databases selected to search for the investigated subject. The first article was published in 2012. However, despite an increase over the years, especially in 2018, 2021 and 2022, with two publications in each year, the average production rate was 1.18 articles per year.

This is corroborated by a scoping review published in 2021, which aimed to characterize publications about palliative care and communication. Eighty-six publications were identified between 2014 and 2018, showing a gradual increase, with a peak in 2017 and 2018 ¹¹11. Andrade CG, Costa ICP, Freire MEM, Dias TKC, França JRFS, Costa SFG. Scientific production about palliative care and communication in online journals: a scoping review. Rev Bras Enferm [Internet]. 2021 [acesso 21 ago 2023];74(2):e20190378. DOI: 10.1590/0034-7167-2019-0378
https://doi.org/10.1590/0034-7167-2019-0... . The growth seems to be related to several variables, including the recognition of palliative care as a specialty and the greater identification of palliative needs.

In relation to the distribution of articles based on country and institutional affiliation of the main author, an important heterogeneity was identified. The 13 articles are distributed across ten countries and eleven institutions, with a large representation from the Asian continent, accounting for 53.8%, and no representatives from the European continent. These data go against a bibliometric study that mapped and analyzed global publication trends on palliative care, according to which the United States and the United Kingdom were the countries with the highest number of publications and citations ²⁴24. Fordjour GA, Chow AYM. Global research trend and bibliometric analysis of current studies on end-of-life care. Int J Environ Res Public Health [Internet]. 2022 [acesso 21 ago 2023];19(18):11176. DOI: 10.3390/ijerph191811176
https://doi.org/10.3390/ijerph191811176... .

A report published by The Economist magazine ²⁵25. The Economist. The 2015 Quality of Death Index: ranking palliative care across the world [Internet]. London: The Economist Intelligence Unit; 2015 [acesso 21 ago 2023]. Disponível: https://bit.ly/3PXnqVK
https://bit.ly/3PXnqVK... on quality of death evaluates the care provided to terminal patients in different countries, considering the availability of human and material resources, in addition to their form of organization. The study ranks the countries, making it possible to compare them with the countries of the institutions to which the main author is affiliated in this study. Among the ten top ranked countries are South Korea and Australia, in 4th. Next come Canada in 22nd, Singapore in 23rd and Japan in 24th. Iran is the only country not mentioned in the report.

A study published in Health magazine in 2015 emphasizes the quality of palliative care provided in South Korea, highlighting the development process and the government efforts made to implement a public policy on the subject from 2004 ²⁶26. Rhee YJ. Hospice and palliative care services in South Korea supported by the National Health Insurance (NHI) Program. Health [Internet]. 2015 [acesso 21 ago 2023];7(6):689-95. DOI: 10.4236/health.2015.76082
https://doi.org/10.4236/health.2015.7608... . Australia, in turn, has had government initiatives since 2000 and is recognized for its excellence in palliative care ²⁷27. Palliative Care Australia. National Palliative Care Standards [Internet]. 5ª ed. Canberra: PCA; 2018 [acesso 21 ago 2023]. Disponível: https://bit.ly/47OLh1v
https://bit.ly/47OLh1v... .

The impact factor, a key piece of data regarding the relevance of scientific journals, is determined from the average number of citations over a given time span: the higher the impact factor, the more relevant the journal ²⁸28. Abu-Odah H, Molassiotis A, Liu JYW. Global palliative care research (2002-2020): bibliometric review and mapping analysis. BMJ Support Palliat Care [Internet]. 2022 [acesso 21 ago 2023];12(4):376-87. DOI: 10.1136/bmjspcare-2021-002982
https://doi.org/10.1136/bmjspcare-2021-0... . The author who published the most on the subject, “Lee J,” was published in a journal with a high impact factor, which points to the relevance of the subject. However, the articles had a low number of citations, with one of them having no citations in the databases.

Networking among the actors is fairly limited, showing low local and global cooperation and the formation of isolated subgroups. This pattern is also noticeable in other studies, such as a bibliometric review that mapped publications on palliative care between 2002 and 2020, showing low international cooperation ²⁸28. Abu-Odah H, Molassiotis A, Liu JYW. Global palliative care research (2002-2020): bibliometric review and mapping analysis. BMJ Support Palliat Care [Internet]. 2022 [acesso 21 ago 2023];12(4):376-87. DOI: 10.1136/bmjspcare-2021-002982
https://doi.org/10.1136/bmjspcare-2021-0... .

When analyzing the methodology of the studies, a prevalence of quantitative approaches is observed, aiming at an objective analysis of knowledge about palliative care. Only two articles used a previously validated questionnaire—the only one found in the study ²⁹29. Kozlov E, Carpenter BD, Rodebaugh TL. Development and validation of the Palliative Care Knowledge Scale (PaCKS). Palliat Support Care [Internet]. 2017 [acesso 21 ago 2023];15(5):524-34. DOI: 10.1017/S1478951516000997
https://doi.org/10.1017/S147895151600099... —the Palliative Care Knowledge Scale (PaCKS). This instrument, developed and published in 2017 in Palliative and Supportive Care , consists of the analysis of 13 items with true or false answers and has been used in several studies. It was administered to assess knowledge about palliative care in Iranian patients ²³23. Atena D, Imane B, Maryam R, Naiire S, Fatemeh T. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care [Internet]. 2022 [acesso 21 ago 2023];21(1):33. DOI: 10.1186/s12904-022-00920-9
https://doi.org/10.1186/s12904-022-00920... , Bangladeshi physicians ³⁰30. Biswas J, Banik PC, Ahmad N. Physicians’ knowledge about palliative care in Bangladesh: a cross-sectional study using digital social media platforms. PLoS One [Internet]. 2021 [acesso 21 ago 2023];16(9):e0256927. DOI: 10.1371/journal.pone.0256927
https://doi.org/10.1371/journal.pone.025... and individuals from Australia ³¹31. Li WW, Singh S, Keerthigha C. A cross-cultural study of filial piety and palliative care knowledge: moderating effect of culture and universality of filial piety. Front Psychol [Internet]. 2021 [acesso 21 ago 2023];12:787724. DOI: 10.3389/fpsyg.2021.787724
https://doi.org/10.3389/fpsyg.2021.78772... , which attests to its reproducibility and validity in different contexts.

Regarding the way in which the knowledge of cancer patients about palliative care is measured in quantitative studies, there is not much standardization. Except for the articles that used the PaCKS questionnaire, there was no definition of the meaning of knowledge about palliative care, based on the proposed instruments. Although the quantitative studies attempted to make the analysis of knowledge on the topic more objective, they presented a better characterization of understanding when evaluating patients’ statements, for example.

Regardless of the method chosen, there is homogeneity in the outcomes: it is concluded that most cancer patients had low to moderate knowledge about palliative care ²⁰20. Chosich B, Burgess M, Earnest A, Franco M, Runacres F, William L et al. Cancer patients’ perceptions of palliative care. Support Care Cancer [Internet]. 2020 [acesso 21 ago 2023];28(3):1207-14. DOI: 10.1007/s00520-019-04917-8
https://doi.org/10.1007/s00520-019-04917... , ²²22. Gupta N, Kumar V, Garg R, Bharati SJ, Mishra S, Bhatnagar S. Initial perceptions about palliative care in patients with advanced cancer: a prospective cross-sectional audit. Indian J Palliat Care [Internet]. 2018 [acesso 21 ago 2023];24(4):512-6. DOI: 10.4103/IJPC.IJPC_94_18
https://doi.org/10.4103/IJPC.IJPC_94_18... , ²³23. Atena D, Imane B, Maryam R, Naiire S, Fatemeh T. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care [Internet]. 2022 [acesso 21 ago 2023];21(1):33. DOI: 10.1186/s12904-022-00920-9
https://doi.org/10.1186/s12904-022-00920... , ³²32. Ozdemir S, Lee JJ, Yang GM, Malhotra C, Teo I, Pham NT et al. Awareness and utilization of palliative care among advanced cancer patients in Asia. J Pain Symptom Manage [Internet]. 2022 [acesso 21 ago 2023];64(4):e195-201. DOI: 10.1016/j.jpainsymman.2022.06.001
https://doi.org/10.1016/j.jpainsymman.20... , ³³33. Chaves JHB, Angelo Neto LM, Tavares VMC, Tuller LPS, Santos CT, Coelho JAPM. Cuidados paliativos: conhecimento de pacientes oncológicos e seus cuidadores. Rev. bioét. (Impr.) [Internet]. 2021 [acesso 21 ago 2023];29(3):519-29. DOI: 10.1590/1983-80422021293488
https://doi.org/10.1590/1983-80422021293... , closely associated with end-of-life care, impossibility of cure and exclusive care for hospitalized patients and cancer patients ¹⁴14. Zimmermann C, Swami N, Krzyzanowska M, Leighl N, Rydall A, Rodin G et al. Perceptions of palliative care among patients with advanced cancer and their caregivers. CMAJ [Internet]. 2016 [acesso 21 ago 2023];188(10):e217-27. DOI: 10.1503/cmaj.151171
https://doi.org/10.1503/cmaj.151171... , ¹⁶16. Akiyama M, Takebayashi T, Morita T, Miyashita M, Hirai K, Matoba M et al. Knowledge, beliefs, and concerns about opioids, palliative care, and homecare of advanced cancer patients: a nationwide survey in Japan. Support Care Cancer [Internet]. 2012 [acesso 21 ago 2023];20(5):923-31. DOI: 10.1007/s00520-011-1161-5
https://doi.org/10.1007/s00520-011-1161-... , ²²22. Gupta N, Kumar V, Garg R, Bharati SJ, Mishra S, Bhatnagar S. Initial perceptions about palliative care in patients with advanced cancer: a prospective cross-sectional audit. Indian J Palliat Care [Internet]. 2018 [acesso 21 ago 2023];24(4):512-6. DOI: 10.4103/IJPC.IJPC_94_18
https://doi.org/10.4103/IJPC.IJPC_94_18... , ³³33. Chaves JHB, Angelo Neto LM, Tavares VMC, Tuller LPS, Santos CT, Coelho JAPM. Cuidados paliativos: conhecimento de pacientes oncológicos e seus cuidadores. Rev. bioét. (Impr.) [Internet]. 2021 [acesso 21 ago 2023];29(3):519-29. DOI: 10.1590/1983-80422021293488
https://doi.org/10.1590/1983-80422021293... .

This finding corroborates previously published reviews, such as the one carried out by Masoud, Imane and Naiire ³⁴34. Masoud B, Imane B, Naiire S. Patient awareness of palliative care: systematic review. BMJ Support Palliat Care [Internet]. 2023 [acesso 21 ago 2023];13(2):136-42. DOI: 10.1136/bmjspcare-2021-003072
https://doi.org/10.1136/bmjspcare-2021-0... , a systemic review on patients’ knowledge about palliative care that included articles published from 2000 to 2021. This study showed that more than half of patients have no knowledge of this approach and mistakenly associate it with end-of-life care.

Final considerations

The data obtained in this bibliometric study made it possible to map the main indicators of the investigated articles on the knowledge of cancer patients about palliative care. The growing interest in the subject in recent years was evident, especially in South Korea, Singapore and Australia.

Despite the exponential growth in publications about palliative care, studies on the knowledge of cancer patients are still scarce. This reveals the need to better understand the gaps that exist in this context, creating opportunities to carry out studies that enable more in-depth discussion.

This study has several limitations, such as the search for original articles in the Scopus and Web of Science databases. The search was carried out using specific keywords found in titles and abstracts, so it may not have included all published articles.

Publication Dates

History