Annals of palliative medicine · 2026
Using strengths-based nursing to introduce the Kerala model of palliative care to Australia-a theoretical integrative narrative review.
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Cheluvappa Damaris, Cheluvappa Rajkumar
Аннотация
BACKGROUND AND OBJECTIVE: Palliative care aims to enhance the quality of life for individuals with life-limiting illness through holistic, person-centred, and family-centred support. However, delivering equitable palliative care in rural/remote Australia remains a persistent challenge due to vast geography, limited clinicians, and diverse community needs. This paper proposes adapting the community-driven, cost-effective Kerala model of palliative care (KMPC)-to rural/remote Australian settings through strengths-based nursing (SBN).
METHODS: The theoretical integrative narrative review methodology was used. Search words included combinations of "Kerala model", "India", "Australia", "telehealth", "end-of-life care", "law", "legislation", "strengths-based nursing", "community nursing", "palliative care", "nursing governance", "rural palliative care", "nursing", and "nurse". Our sources include reports, guidelines, and publications from Government repositories and research portals like PubMed and Google Scholar. Our searches resulted in about 40 publications and 10 reports, which were match-analyzed and integrated to critically evaluate the applicability of the KMPC using SBN in rural/remote Australia.
KEY CONTENT AND FINDINGS: The KMPC, developed in Kerala (India), demonstrates near-universal access to palliative care despite limited resources. Its success is attributable to decentralised governance, community participation, home care units (HCUs), broad-based funding sources, and flexible integration of trained volunteers, social workers, nurses, and family caregivers. SBN complements this model by mobilising local strengths, fostering community capability, and enabling collaborative, holistic care. The paper describes three SBN phases-pre-commitment, pre-adoption, and adoption-and details the legislative, organisational, and workforce requirements for establishing Australian SBN-guided HCUs with community involvement. Evidence from Australian telehealth initiatives, rural palliative care models, and community-integrated care trials demonstrates the feasibility of combining KMPC principles with existing local frameworks, nurse-led coordination, community engagement, accredited training pathways, and telehealth support. Challenges include legislative reform, decentralisation of services, funding constraints, workforce training, and the need to adapt Kerala's sociocultural strengths to the Australian context.
CONCLUSIONS: SBN-enabled adaptation of the KMPC offers a sustainable, culturally responsive, and cost-effective pathway to improving palliative care access and quality in rural/remote Australia. By leveraging community capacity, strengthening interdisciplinary collaboration, and integrating telehealth innovations, this model has the potential to enhance patient comfort, reduce unnecessary hospitalisation, and deliver high-quality end-of-life (EOL) care closer to home.
METHODS: The theoretical integrative narrative review methodology was used. Search words included combinations of "Kerala model", "India", "Australia", "telehealth", "end-of-life care", "law", "legislation", "strengths-based nursing", "community nursing", "palliative care", "nursing governance", "rural palliative care", "nursing", and "nurse". Our sources include reports, guidelines, and publications from Government repositories and research portals like PubMed and Google Scholar. Our searches resulted in about 40 publications and 10 reports, which were match-analyzed and integrated to critically evaluate the applicability of the KMPC using SBN in rural/remote Australia.
KEY CONTENT AND FINDINGS: The KMPC, developed in Kerala (India), demonstrates near-universal access to palliative care despite limited resources. Its success is attributable to decentralised governance, community participation, home care units (HCUs), broad-based funding sources, and flexible integration of trained volunteers, social workers, nurses, and family caregivers. SBN complements this model by mobilising local strengths, fostering community capability, and enabling collaborative, holistic care. The paper describes three SBN phases-pre-commitment, pre-adoption, and adoption-and details the legislative, organisational, and workforce requirements for establishing Australian SBN-guided HCUs with community involvement. Evidence from Australian telehealth initiatives, rural palliative care models, and community-integrated care trials demonstrates the feasibility of combining KMPC principles with existing local frameworks, nurse-led coordination, community engagement, accredited training pathways, and telehealth support. Challenges include legislative reform, decentralisation of services, funding constraints, workforce training, and the need to adapt Kerala's sociocultural strengths to the Australian context.
CONCLUSIONS: SBN-enabled adaptation of the KMPC offers a sustainable, culturally responsive, and cost-effective pathway to improving palliative care access and quality in rural/remote Australia. By leveraging community capacity, strengthening interdisciplinary collaboration, and integrating telehealth innovations, this model has the potential to enhance patient comfort, reduce unnecessary hospitalisation, and deliver high-quality end-of-life (EOL) care closer to home.