Patient and carer involvement in palliative care research: An integrative qualitative evidence synthesis review.

21 , 56 , 66 , 67 Organisations and culture Involvement was influenced by wide contextual factors including international perspectives and local politics 46 , 51 ; however, organisational culture was also highly significant. 4 , 50 , 67 , 82 Involvement needed to be considered a core activity, integrated throughout organisations at different levels 5 , 49 , 56 , 83 ; however, systems often were not perceived as being involvement-friendly.

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