title: Rural end-of-life care from the experiences and perspectives of patients and family caregivers: A systematic literature review.
abstract: BACKGROUND
  End-of-life care must be relevant to the dying person and their family caregiver regardless of where they live. Rural areas are distinct and need special consideration. Gaining end-of-life care experiences and perspectives of rural patients and their family caregivers is needed to ensure optimal rural care.
  
  
  OBJECTIVE
  To describe end-of-life care experiences and perspectives of rural patients and their family caregivers, to identify facilitators and barriers to receiving end-of-life care in rural/remote settings and to describe the influence of rural place and culture on end-of-life care experiences.
  
  
  METHODS
  A systematic literature review utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
  
  
  METHODS
  Four databases (PubMed, CINAHL, Scopus and Web of Science) were searched in January 2016, using a date filter of January 2006 through January 2016; handsearching of included article references and six relevant journals; one author contacted; pre-defined search terms and inclusion criteria; and quality assessment by at least two authors.
  
  
  RESULTS
  A total of 27 articles (22 rural/remote studies) from developed and developing countries were included, reporting rural end-of-life care experiences and perspectives of patients and family caregivers. Greatest needs were informational (developed countries) and medications (developing countries). Influence of rural location included distances, inaccessibility to end-of-life care services, strong community support and importance of home and 'country'.
  
  
  CONCLUSIONS
  Articulation of the rural voice is increasing; however, there still remain limited published rural studies reporting on patient and family caregivers' experiences and perspectives on rural end-of-life care. Further research is encouraged, especially through national and international collaborative work.
authors.affiliation: 1 Medical School, Australian National University, Canberra, ACT, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Rainsford
authors.affiliation: 2 HammondCare, Sydney, NSW, Australia.|3 Palliative Medicine, University of Sydney, Sydney, NSW, Australia.
authors.forename: Roderick D
authors.initials: RD
authors.lastname: MacLeod
authors.affiliation: 1 Medical School, Australian National University, Canberra, ACT, Australia.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Glasgow
authors.affiliation: 1 Medical School, Australian National University, Canberra, ACT, Australia.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Phillips
authors.affiliation: 4 Rural Clinical School, Australian National University, Cooma, NSW, Australia.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wiles
authors.affiliation: 5 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada.
authors.forename: Donna M
authors.initials: DM
authors.lastname: Wilson
mesh_terms: D017028:Caregivers / Q000523:psychology; D003469:Culture; D006297:Health Services Accessibility / Q000592:standards; D006301:Health Services Needs and Demand; D006801:Humans; D010166:Palliative Care / Q000592:standards; D017060:Patient Satisfaction; D019035:Rural Health Services / Q000458:organization & administration / Q000592:standards*; D013727:Terminal Care / Q000592:standards*
keywords: Palliative care; caregiver; end-of-life care; family; patient; rural; systematic review