Patients, their Families and Carers, and Interested Citizens Involvement in Palliative Care Research

What is PPI?

PPI is a term used in health and social care research. On the island of Ireland PPI refers to Personal and Public Involvement or Public and Patient Involvement in research.

What is PPI in palliative care research?

PPI in palliative care research actively supports and facilitates people with life-limiting conditions, their families, and carers, and members of the public with an interest in palliative and end of life care to be involved in all stages of palliative care research. It empowers PPI volunteers to partake in research decision-making.

“At every step of my research career, the voices of people with intellectual disability have guided, advised and championed the work that I’ve done. Their lived experience has informed so many aspects of my work, they have advocated for research and have provided me with endless enthusiasm to keep moving forward, ensuring that my research has real-world impact. Public and Patient Involvement (PPI) has been a core part of my research approach for many years. Without understanding the lived experience of those we research, we deny ourselves the opportunity for better research, greater impact and deeper insight. Working in real partnership with PPI contributors is not easy, but for those who persevere, the rewards are great.”

Professor Mary Mc Carron,
Director, Trinity Centre for Ageing and Intellectual Disability,
Trinity College Dublin

PPI in palliative care research may include:

Identifying research priorities

Informing research questions

Supporting a research grant application

Sitting on research steering committees

Advising on research participation and recruitment methods

Reviewing and/or co-designing research outputs

Inputting into the development of research events

Attendance and/or participation at research events

Supporting the dissemination of research messages throughout the research project and beyond

Advocating for implementation of the research findings

Why is PPI important?

People’s lived experiences can contribute to identifying gaps in palliative care services, information and supports, and spotlight issues which may not be apparent to the research team and/or service providers.

“I cannot stress enough how important it is to involve PPI members from the very start of any research project. As an example, members of the public were involved in the drafting of a recent successful application to the National Institute for Health Research, Health Services and Delivery Research (NIHR HS&DR). We sought feedback on the importance of our proposed study, what we should focus on in our review and our Plain English summary from members of two established public involvement and engagement groups. I believe our PPI members were integral to the success of this funding application, and this was further evidenced by feedback from the funding panel who welcomed their unique insights into what was important to include in the aims of our project.”

Dr Tracey McConnell, Marie Curie Senior Research Fellow,
School of Nursing & Midwifery, Queen’s University Belfast

How do AIIHPC support PPI?

All Ireland Institute of Hospice and Palliative Care (AIIHPC) can provide members of our Palliative Care Research Network (PCRN), Early Career Researcher Forum (ECRF) and partner organisations with support and guidance when planning and conducting PPI.

Voices4Care
The meaningful involvement of people with a life-limiting illness, their families and carers or former carers, and people from the wider community with an interest in palliative and end of life care, is a core priority for AIIHPC. Voices4Care was set up by AIIHPC in 2013. Membership is voluntary. Members include people with life-limiting conditions, family carers, former carers and citizens interested in improving palliative care. Voices4Care influence the work of AIIHPC and the wider palliative care arena across health and social care in both the Republic of Ireland and Northern Ireland. Members’ contributions make a real difference, and influence palliative care education, research, policy and practice.

Voices4Care members welcome opportunities to contribute to AIIHPC PCRN and ECRF members’ research. You can submit a request for involvement of Voices4Care members in your research project by completing this form: Voices4Care Involvement in Research Request Form

For further information please contact Jane Clare, AIIHPC PCRN Project Manager at jclare@aiihpc.org.

How to measure PPI Impact

Introduction

This Public and Patient Involvement (PPI) Impact Evaluation Framework was developed to support researchers to measure PPI impact in palliative and health care research using quantitative and qualitative methods.

AIIHPC co-produced the framework with PPI contributors from AIIHPC’s Voices4Care and researchers from AIIHPC’s Palliative Care Research Network and Early Career Research Forum, in collaboration with the PPI Ignite Network at University College Cork.  This included an initial literature review to identify current practices in conducting PPI in research and evaluating impact. Followed by focus groups with PPI contributors and researchers to identify key themes for evaluating PPI impact. The results of the review and focus groups were used to inform the development of a draft framework. This draft framework was then reviewed by AIIHPC and an external expert, piloted with researchers, and updated to produce this PPI Impact Evaluation Framework to support palliative and health care researchers.  


Framework Benefits

This framework offers clear guidance on documenting and evaluating PPI for palliative and health care research across the research cycle, from initial design through to delivery and dissemination. This framework supports researchers to:

  • Collaborate effectively with patients, families, caregivers, and interested citizens
  • Develop research that aligns with the lived experiences and priorities of those receiving palliative care, and their families and caregivers
  • Systematically document the impact of PPI in research to support for example in:
    • Grant funding proposals
    • Project evaluations and final grant funder reports
    • Publicity materials such as press releases
    • Research dissemination and implementation strategies
    • Impact assessments on policy and practice
    • Research Assessment Exercises (RAEs) submissions to demonstrate the value and reach of research activities


Framework Principles

This framework is based on the following principles:

  1. Respect, Trust, and Transparency between both collaborators and study organisers which facilitates an environment of open evaluation and development.  
  2. Equality, Collaboration, and Inclusion which ensures that study collaborators are dually involved in the PPI process with all contributions being valued and reflected in the collaborative outcomes.
  3. Research Excellence, Curiosity, and Empowerment to promote the output of research that is impactful and relevant in palliative care and wider health care.


How to use this framework

This framework will support researchers to measure:

  1. Overall Public and Patient Involvement
  2. Co-Produced Outputs across Research Cycle
  3. Partnerships and Collaborations Established
  4. Public Awareness and Media Engagement
  5. Overall PPI Research Impact

The framework includes the following forms:

  • PPI Impact Evaluation Form: to be completed by the researcher(s) in collaboration with PPI contributor(s)
  • PPI Contributor Feedback Form: to share with PPI Contributor(s) so they can document their experience
  • PPI Reporting Checklist: to help researchers determine best practice for including PPI in research design, delivery and dissemination including reporting research outputs

This framework is designed for researchers to use across all stages of the research cycle in collaboration with PPI contributors. It is recommended that even at the early stages this framework can researchers to consider and plan for impactful research outcomes with PPI contributors. 

Note: Not all form or sections may be relevant however it is recommended that the PPI Impact Evaluation Form and Section 1 is completed as a minimum.

Download the PPI Impact Evaluation Framework document here.

If you are a member of AIIHPC PCRN or ECRF and would like more information or to have your completed Framework published on Research Studies please contact Jane Clare, AIIHPC PCRN Project Manager at jclare@aiihpc.org

Helpful resources

PPI Within the Context of Palliative Care Research (Online workshop, held March 2022)

Personal and Public Involvement in Research, Health and Social Care Public Health Agency Research and Development.

Public and Patient Involvement in Research, Health Research Board.

PPI in Clinical Research, The Irish Platform for Patient Organisations, Science and Industry

UK Standards for Public Involvement in Research

Making a start: A toolkit for research charities to being a PPI relationship, Health Research Charities Ireland

New to Research Public and Patient Involvement: A Guide for Not-for Profit and Community Groups, Care Alliance Ireland

eLearning: ‘What is Public and Patient Involvement (PPI)?’, Trinity PPI Ignite Introductory Module

Templates: ‘PPI resources’, Trinity PPI Ignite

Case studies and resources: ‘PPI Hub, IPPOSI

Designing a tool to support patient and public involvement in research projects, the Involvement Matrix, Smits, DW., van Meeteren, K., Klem, M. et al. Res Involv Engagem 6, 30 (2020). Doi. https://doi.org/10.1186/s40900-020-00188-4

GDPR information:

Health Research Authority (HRA, United Kingdom) GDPR guidance

Health Research Board (HRB, Republic of Ireland) Guidance on Information Principles