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Service Level Characteristics of Rural Palliative Care for People with Chronic Disease.
- Source :
-
Journal of pain and symptom management [J Pain Symptom Manage] 2023 Oct; Vol. 66 (4), pp. 301-309. Date of Electronic Publication: 2023 Jun 20. - Publication Year :
- 2023
-
Abstract
- Context: Despite clear benefit from palliative care in end-stage chronic, non-malignant disease, access for rural patients is often limited due to workforce gaps and geographical barriers.<br />Objectives: This study aimed to understand existing rural service structures regarding the availability and provision of palliative care for people with chronic conditions.<br />Methods: A cross-sectional online survey was distributed by email to rural health service leaders. Nominal and categorical data were analyzed descriptively, with free-text questions on barriers and facilitators in chronic disease analyzed using qualitative content analysis.<br />Results: Of 42 (61.7%) health services, most were public (88.1%) and operated in acute (19, 45.2%) or community (16, 38.1%) settings. A total of 17 (41.5%) reported an on-site specialist palliative care team, primarily nurses (19, 59.5%). Nearly all services (41, 95.3%) reported off-site specialist palliative care access, including: established external relationships (38, 92.7%); visiting consultancy (26, 63.4%); and telehealth (18, 43.9%). Perceived barriers in chronic disease included: lack of specific referral pathways (18; 62.1%); negative patient expectations (18; 62.1%); and availability of trained staff (17; 58.6%). Structures identified to support palliative care in chronic disease included: increased staff/funding (20, 75.0%); formalized referral pathways (n = 18, 64.3%); professional development (16, 57.1%); and community health promotion (14, 50%).<br />Conclusion: Palliative care service structure and capacity varies across rural areas, and relies on a complex, at times ad hoc, network of onsite and external supports. Services for people with chronic, non-malignant disease are sparse and largely unknown, with a call for the development of specific referral pathways to improve patient care.<br /> (Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1873-6513
- Volume :
- 66
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of pain and symptom management
- Publication Type :
- Academic Journal
- Accession number :
- 37343902
- Full Text :
- https://doi.org/10.1016/j.jpainsymman.2023.06.003