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Abstract: Background: Interprofessional collaboration is an important part of palliative care. Effective communication and information exchange is essential for a high quality of care. The aim of this study was to test the effectiveness of a new tool for exchanging information between professionals in palliative care on primary healthcare level. Methods: With suggestions from the experts regarding palliative care needs in an interprofessional team from the Delphi study and community nurses from the field, we developed a paper version of the tool. The paper version was tested in a pilot phase, and subsequently, we conducted ten semi-structured interviews with the users of the new tool to test its feasibility and usability. The data were analyzed using qualitative content analysis, leading to improvement and development of the digital version of the new tool. Results: After completing the pilot phase of the research, we identified the following four categories: a systematic tool for more consistent treatment and better communication during the patient’s visit; training and empowerment; quality, safety and digitalization; these categories were later included in the final version of the digital communication tool. Conclusion: Effective palliative care requires a good exchange of information and communication between all care professionals who work with the patient. Effective communication contributes to making patients and their relatives feel safe in their home environment and allows patients to stay in their homes even as their disease progresses. The systematical new tool was assessed as useful to improve interdisciplinary cooperation and prepared in a digital version. Further research after the long-term use of the developed digital tool in everyday work might confirm its sustaining importance.
Keywords: palliative care, family medicine, interprofessional collaboration, telemedicine
Published in DKUM: 09.07.2024; Views: 104; Downloads: 12
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Abstract: Introduction: Palliative care aims to provide an early person-centred approach to patients with non-communicable disease(s) by monitoring distressing symptoms, providing support at all four domains of health, supporting their care partners, and enhancing the quality of patients and their care partners' lives. A problem lies in the late introduction of person-centred palliative care in acute care and the emergence of barriers to providing such care. Therefore, the present doctoral thesis explores the perceptions of person-centred palliative care of healthcare professionals and patients with non-communicable disease(s). Based on the results of both data analyses, we identified the key components of a model to provide person-centred palliative care for patients and their care partners. Methods: A two-phase sequential explanatory design was used, which involved collecting data in consecutive phases between August 2020 and July 2021. The study's first phase involved health professionals and patients from eight institutions, and the second phase involved health professionals, patients and care partners. Data from the first part of the study were gathered using validated questionnaires, and inferential and descriptive statistics were used to analyse the results. Semi-structured interviews were used in the second phase to collect data, then thematically analysed. We have merged the outcomes of the quantitative and qualitative stages utilising the pillar integration approach in order to interpret them in a more thorough and comprehensive manner. Results: Through the data integration process, we identify four key components to providing person-centred palliative care in patients with non-communicable disease(s). These components are: (1) Healthcare professionals' prerequisites and traits; (2) Person-centred palliative care environment; (3) Person-centred palliative process; and (4) Person-centred palliative care outcome. A Healthcare professional's prerequisites and traits can be said to contain three aspects: (1) Attitudes, (2) Commitment to the work and (3) Values and beliefs. When these three aspects are considered, a person-centred palliative care environment can be created. Here it is important to consider four aspects: (1) Transdisciplinary approach; (2) Patient empowerment; (3) Partner engagement; and (4) Institution/policy climate. A person-centred palliative process that allows the patient to maintain their quality of life and dignity includes the following aspects: (1) Person-centred approach; (2) Establishing an advance care plan; (3) Early integration of person-centred palliative care, and (4) Enlightenment and raising awareness. Person-centred palliative care outcomes can be (1) Positive experiences and (2) Negative experiences. Discussion and conclusion: Person-centred palliative care is essential in treating patients with non-communicable diseases. For that reason, it is pivotal to follow the four key components of how to provide person-centred palliative care, comprising: (1) Healthcare professionals' prerequisites and traits, (2) The person-centred palliative environment, (3) The person-centred palliative process and (4) The person-centred palliative outcomes. These four key components provide healthcare professionals and transdisciplinary palliative teams with the steps for providing person-centred palliative care to the patient and support to the care partners. The term ‘patient’ is herein used to denote patients with one or more non-communicable disease(s).
Keywords: person-centred care, palliative care, patients, care partners, healthcare professionals', mixed-method, sequential explanatory design
Published in DKUM: 10.11.2023; Views: 702; Downloads: 233
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