Nine articles were included in the review: six qualitative or survey designs, two mixed-methods designs and one quantitative (questionnaire) design. Overall, methodological quality was considered to be fair (average 26.5 out of 40 points). Two articles scored over 30 points. The quality of most was diminished by failure to address ethics and bias. Exclusion of a tenth eligible article on the grounds of poor quality did not materially affect the main findings.
Healthcare support workers were involved in providing personal care, emotional and social support for patient and family, domestic support, respite care for family carers and collaborating with professional and family carers. Within these roles, the specific challenges to care provision (perceived as potential sources of increased work-related stress among healthcare support workers) included issues around inadequate training (five studies), role ambiguity between professional and informal care (three studies) and emotional attachment (two studies).
The authors stated that informal peer grief-support groups, sense of cohesiveness among colleagues and task orientation acted as support factors for healthcare support workers in providing palliative end-of-life care in the community.