title: Education in advanced disease.
abstract: BACKGROUND
  In advanced disease, the management of symptoms and lifestyle are essential for the maintenance of patients' quality of life. Appropriate education by health professionals can help patients to better manage their disease. Although the provision of education by health professionals for patients with advanced cancer is reasonably well documented, much less is known about how health professionals facilitate education with patients with other advanced progressive diseases.
  
  
  OBJECTIVE
  The aim of this review was to synthesize qualitative research examining health professionals' knowledge of, attitudes toward, and ability to deliver educational interventions for symptom and disease management to patients with advanced progressive diseases other than cancer.
  
  
  METHODS
  The synthesis was conducted using meta-ethnography. Systematic searching of five electronic databases (CINAHL, Medline, PsycInfo, Web of Science Social Science Citation Index, and EMBASE) was performed. Included studies were data extracted and assessed for quality.
  
  
  RESULTS
  Systematic searching of four electronic databases identified 911 records; 17 studies met review inclusion criteria and underwent data extraction and quality appraisal. Three key factors were identified that influenced the delivery of education by health professionals to patients with advanced disease: capacity (to educate and aid decision making), context (of educational delivery), and timing (of education).
  
  
  CONCLUSIONS
  Health professionals identify and acknowledge a range of factors that influence their ability to deliver education to patients with advanced disease. The types of circumstantial factors identified in this review can influence the successful delivery of educational interventions and need to be considered when such interventions are being developed.
authors.affiliation: Department of Health Sciences, The University of York, Heslington, York, United Kingdom. kate.flemming@york.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Flemming
authors.forename: S José
authors.initials: SJ
authors.lastname: Closs
authors.forename: Robbie
authors.initials: R
authors.lastname: Foy
authors.forename: Michael I
authors.initials: MI
authors.lastname: Bennett
mesh_terms: D003657:Decision Making; D003695:Delivery of Health Care; D006282:Health Personnel / Q000193:education*; D006801:Humans; D010166:Palliative Care; D013727:Terminal Care