This thesis synthesises and evaluates the evidence base of key areas in public health and palliative care research. The author’s published works are integrated throughout and critical discussion of methodological and theoretical aspects are expanded. The principal aims include optimisation of self-management of long-term conditions and the improvement of access to healthcare for marginalised groups. It also specifically examines improved quality of care through the delivery of appropriate communication skills, and the identification of reliable and valid outcomes for people affected with illness or disability. Broader aims include improved patient satisfaction with health care services and an evaluation of systemic aspects of care and patient, public involvement in research.