Evidence map›Paper›PMID 41975373›Full record

SynthesisBMC palliative care2026

Exploring strategies and approaches to improve end-of-life care services for people experiencing homelessness: a systematic review and meta-synthesis of qualitative studies.

Lijie Tian, Lili Guo, Zhongying Jiang, Xiaole Zhu, Mingmin Luo, Zhiguang Chen

Abstract readSystematic Review
In one paragraph

Synthesis in BMC palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lijie Tian *Department of Emergency Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China.
Lili Guo *Department of Emergency Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China.
Zhongying JiangOperating Room, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China. 912408612@qq.com.
Xiaole ZhuDepartment of Emergency Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China. 983248068@qq.com.
Mingmin LuoDepartment of Emergency Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China.
Zhiguang ChenDepartment of Emergency Medicine, Shengjing Hospital of China Medical University, Sanhao Street, Shenyang, 110001, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAs a socially disadvantaged group, people experiencing homelessness face numerous difficulties and challenges in accessing end-of-life (EOL) care. Existing strategies often fail to meet their needs, with evident deficiencies in workforce allocation, financial support, and service coverage, as well as a lack of consideration for their unique circumstances.

objectiveThis study synthesizes published qualitative research to explore the expectations and needs of people experiencing homelessness in EOL care, as well as the perspectives of service providers. Its aim is to identify effective strategies and approaches to improve EOL care services for this population, ultimately promoting more targeted and higher-quality care.

methodsWe systematically searched PubMed, Web of Science, CINAHL, Embase, Cochrane Library, and CNKI from inception to November 2024 for primary qualitative studies addressing the EOL needs and service challenges of homeless populations. Using inductive thematic analysis in conjunction with Bronfenbrenner’s ecological systems theory, we examined systemic barriers and potential solutions across the microsystem, mesosystem, exosystem, macrosystem, and chronosystems, providing a critical framework for building an inclusive EOL care ecosystem for people experiencing homelessness.

resultsA total of 20 publications representing 16 independent studies were included. The synthesis yielded four major findings: People experiencing homelessness’ EOL Dilemmas and Attitudes, EOL care from the perspective of service providers, Challenges and Barriers to EOL Care, Strategies and Recommendations for Improving EOL Care Furthermore, by applying Bronfenbrenner’s ecological systems theory, these findings were integrated into a cross-system, multi-level analytical framework.

conclusionThis study systematically synthesized qualitative evidence on EOL care for people experiencing homelessness, revealing the multifaceted challenges and profound structural barriers they face at the EOL. Our synthesis indicates that the lack of trust and the need for dignity permeate all systemic levels, from the micro to the macro, in EOL care for this population. Reliance on traditional biomedical models alone may not fully address their complex needs. Future efforts should be further advanced through cultural sensitivity, cross-sectoral collaboration, and service evaluation, in order to build an inclusive, respectful, and diverse EOL care system that ensures equitable and dignified care for people experiencing homelessness.

Indexed as

Ill-Housed PersonsTerminal CareHealth Services AccessibilityHumansQualitative ResearchBronfenbrenner’s ecological systems theoryEOL careHomelessness

Identifiers

PMID41975373
PMCPMC13072573

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.