Search

Palliative care improves outcomes, yet rural residents often lack adequate and equitable access. This study provides practical tips to address palliative care (PC)-related challenges in rural communities. Strategies include engaging trusted community partners, addressing cultural factors, improving pediatric care, utilizing telehealth, networking with rural teams including caregivers, and expanding roles for nurses and advanced practice providers. Despite complex barriers to access, providers can tailor PC to be patient-centered, respect local values, and bridge gaps. The "Top 10" format emphasizes the relevant issues to enable clinicians to provide optimal care for people from rural areas.

Objectives: This study aimed to explore health professional, patient, family, and caregiver perceptions of palliative care, availability of palliative care services to patients across South Dakota, and consistency and quality of palliative care delivery., Methods: Six focus groups were conducted over two months. Participants included interprofessional healthcare team members, patients, family members of patients, and caregivers. Individuals with palliative care experiences or interest in palliative care were invited to participate. Recruitment strategies included emails, flyers, and direct contact by members of the Network. Snowball sampling was used to recruit participants., Results: Forty-six participants included patients, family members, caregivers and interprofessional health care team members. Most participants were Caucasian (93.3%) and female (80%). Six primary themes emerged: Need for guidance toward the development of a holistic statewide palliative care model; Poor conceptual understanding and awareness; Insufficient resources to implement complete care in all South Dakota communities; Disparities in the availability and provision of care services in rural SD communities; Need for relationship and connection with palliative care team; and Secondary effects of palliative care on patients/family/caregivers and interprofessional healthcare team members. Significance of Results: Disproportionate access is a principle problem identified for palliative care in rural South Dakota. Palliative care is poorly understood by providers and recipients of care. Service reach is also tempered by lack of resources and payer reimbursement constraints. A model for palliative care in these rural communities requires concerted attention to their unique needs and design of services suited for the rural residents.

Purpose: To explore the effectiveness of education on increasing knowledge of palliative care and how to access palliative care services among community members. Design: A descriptive study using a retrospective survey was conducted after in-person educational events on palliative care. This study used the definition of rural and frontier provided by the South Dakota Department of Health which is based on the US Census Bureau population estimates (2020). Sample: Educational events occurred in 17 communities across South Dakota with 256 community members. Of which, 166 people completed the survey. Methods: Wilcoxon signed rank test was performed to evaluate for change in palliative care knowledge. Fisher's Exact Test was utilized to analyze for an association between past palliative and hospice care use, palliative care knowledge, and confidence in finding palliative care services. Findings: The majority of educational events took place in rural or frontier locations with 85% of participants and 95.2% of survey respondents attending in a rural or frontier location. Most of the survey respondents (61.5%) were a caregiver of someone with a serious health condition, while 13.3% had a serious health condition and 3% were both a caregiver and had a serious health condition. After completion of the community education program, community members demonstrated a statistically significant improvement in their knowledge of palliative care and their confidence in being able to locate palliative care services, p <.001. Having used palliative care services was significantly associated with palliative care knowledge and confidence in accessing these services, p < .001. Conclusion: Performing education individualized to each community increased knowledge regarding palliative care and how to access these services. Additional needs of community members were discovered which is critically important to address as the rural population ages and is more likely to be living with serious illness(es). [ABSTRACT FROM AUTHOR]

In 2018, the Avera Sacred Heart Hospital and two partners were awarded a planning grant to improve palliative health care services in South Dakota (SD), United States, by assessing palliative care in rural SD communities. Through this effort, a newly formed South Dakota Palliative Care Network (SDPCN) convened statewide partners to develop a palliative care strategy for improving quality palliative care access for individuals with serious illness. Guided by a multidisciplinary governing board, the SDPCN completed needs assessments to (1) better understand the perception of palliative care in SD; (2) assess the palliative care landscape in the state; and (3) explore possible solutions to address the uneven access to palliative care. This article shares the process of network development, considers the future of the SDPCN, and provides a blueprint for improving palliative care in rural areas. The SDPCN sought first to inventory community-based palliative care resources and increase awareness of the need for services followed by addressing gaps identified through a comprehensive assessment. The SDPCN has engaged partners, captured data, and mapped a blueprint for sustaining accessible quality palliative care. Three years since its inception, the SDPCN secured additional funding to sustain the Network and to provide education on palliative care to providers and community members as a first strategic step toward improving overall palliative care in rural communities. The SDPCN currently serves rural SD patients by increasing knowledge of palliative care among health professionals (current and future), fostering Network member engagement, and maintaining an active governing board. [ABSTRACT FROM AUTHOR]