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Discontinuity of care at end of life: a qualitative exploration of OOH end of life care
- Source :
- BMJ Supportive & Palliative Care. 3:412-421
- Publication Year :
- 2013
- Publisher :
- BMJ, 2013.
-
Abstract
- Objective This study aimed to understand the experiences of palliative care patients when accessing or making decisions about out of hours (OOH) services. It also aimed to illuminate barriers and enablers to accessing appropriate and timely care following the introduction of the 2004 New General Medical Services Contract. Method Longitudinal prospective qualitative study using semi-structured interviews and telephone interviews over 6 months and analysed for thematic content. 32 patients defined as receiving palliative care in six General Practices and three hospices selected on the basis of size and rural/urban location in Southern England were recruited. Results Continuity of care was highly valued. Participants described the importance of being known by the healthcare team, and the perceived positive implications continuity could have for the quality of care they received and the trust they had in their care. Various factors prevented participants from seeking help or advice from OOH services, despite having health concerns that may have benefitted from medical assistance. Prior poor experience, limited knowledge of services and knowing who to call and, indeed, when to call were all factors that reportedly shaped participants’ use of OOH services. Conclusions Interpersonal or relationship continuity and management continuity are vital to the process of optimising the patient experience of OOH palliative care. While recent service innovations are tackling some of the issues highlighted, this research reinforces the value patients with palliative care needs places on continuity and the need to improve this aspect of care management.
- Subjects :
- Male
medicine.medical_specialty
Palliative care
General Practice
Medicine (miscellaneous)
General medical services
Health Services Accessibility
Patient satisfaction
After-Hours Care
Nursing
Patient experience
Health care
medicine
Humans
Longitudinal Studies
Prospective Studies
Cooperative Behavior
Qualitative Research
Aged
Aged, 80 and over
Patient Care Team
Service (business)
Health Services Needs and Demand
Physician-Patient Relations
Terminal Care
Oncology (nursing)
business.industry
General Medicine
Continuity of Patient Care
Middle Aged
Medical–Surgical Nursing
Hospice Care
England
Withholding Treatment
Patient Satisfaction
Family medicine
Female
Interdisciplinary Communication
Nurse-Patient Relations
business
End-of-life care
Qualitative research
Subjects
Details
- ISSN :
- 20454368 and 2045435X
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- BMJ Supportive & Palliative Care
- Accession number :
- edsair.doi.dedup.....d7401b51172673875be60df0a3fffcc4