Aim: Little is known about what enhances well-being for refugees with advanced life-limiting illness and their families after resettlement in high-income countries. We conducted a systematic review to identify factors that enhanced well-being for refugees and their families during end-of-life care and bereavement.
Methods: We systematically reviewed empirical studies published between 2003 and 2024. We searched the following electronic databases: MEDLINE, EMBASE, CINAHL, PSYCHInfo, Web of Science Core Collection, Scopus, Proquest Dissertations and Theses Global, and Overton. We applied a strength-based asset framework to data extraction and synthesis and conducted a directed content analysis.
Results: Ten of the 1006 studies identified were included in the review: two qualitative and one quantitative; and seven case studies. Six of the included studies involved either single case participants with cancer, their spouse or other family and friends. We identified 17 assets that enhanced well-being: resilience, religion, spirituality, identity and belonging, community connections, health and death literacy, acculturation, family and community support, social capital, community structures, access to funeral information, access to services, palliative care approaches and workforce capacity. Many assets were linked with resilience. The role of identity and community in strengthening resilience and social support was highlighted, through connections within cultural and religious networks. Social capital, as a resource inherent to social networks, could facilitate access to acceptable end-of-life care provided by community members, and the development of meaningful mourning and funeral rituals for refugees in resettlement. Palliative care approaches need to respond to refugees’ experiences of loss and grief and enhance communication with families about treatment goals, prognosis and spiritual care.
Conclusions: Further research, co-designed with diverse groups of people from refugee backgrounds, is needed to inform palliative care service approaches, develop effective interventions and explore in a more nuanced manner the role of social capital in promoting and protecting wellbeing.