• Dylan Weisman Zhao, RobinsonShahar GevaSGFaculty of Health Sciences, Ben-Gurion University of Negev, Soroka University Medical Centre, Beer Sheva, Israel., Rachel Pozzar, Richard Leiter, Chris Walsh, Isaac Siemens, Emily Lovrics, Victor Cellarius, Ramona Mahtani, and Zhimeng Jia.
• Department of Translational Medicine, School of Medicine, Queen's University, Kingston, Ontario, Canada. dylan.zhao@queensu.ca.
• J Gen Intern Med. 2024 Mar 1; 39 (4): 661682661-682.

BackgroundPalliative care performed a central role in responding to the systemic suffering incurred by the COVID-19 pandemic. Yet, few studies have elucidated the inpatient palliative care specialists' experiences and perceptions.ObjectiveSystematically review and synthesize the evolving roles and expectations of inpatient palliative care specialists in response to COVID-19.DesignA systematic review and meta-synthesis informed by Thomas and Harden's framework and Pozzar et al.'s approach was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.Data SourcesMEDLINE, EMBASE, CINAHL, and PubMed were systematically searched for articles published between December 2019 and March 2023. We included all peer-reviewed qualitative and mixed-method literature studying the roles and expectations of inpatient palliative care specialists. A mixed-method appraisal tool was used for quality assessment.ResultsOf 3869 unique articles, 52 were included. Studies represented North American (n = 23), European (n = 16), South American (n = 4), Oceanic (n = 2), Asian (n = 2), West African (n = 1), Middle Eastern (n = 1), and inter-continental settings (n = 3). Most were reported in English (n = 50), conducted in 2020 (n = 28), and focused on the perspectives of inpatient palliative care clinicians (n = 28). Three descriptive themes captured the roles and expectations of inpatient palliative care specialists: shifting foundations, reorienting to relationships, and evolving identity. Two analytical themes were synthesized: palliative care propagates compassion through a healing presence, and palliative care enhances the systemic response to suffering through nimble leadership.ConclusionInpatient palliative care specialists responded to the COVID-19 pandemic by establishing their healing presence and leading with their adaptability. To develop institutionally tailored and collaborative responses to future pandemics, future studies are needed to understand how inpatient palliative care clinicians are recognized and valued within their institutions.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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