Abstract
Abstract
Background
Patients in need of palliative care often want to reside at home. Providing palliative care requires resources and a high level of competence in primary care. The Norwegian guideline for palliative care points to the central role of the regular general practitioner (RGP), specifying a high expected level of competence. Guideline implementation is known to be challenging in primary care. This study investigates adherence to the guideline, the RGPs experience with, and view of their role in palliative care.
Methods
A questionnaire was distributed, by post, to all 246 RGPs in a Norwegian county. Themes of the questionnaire focused on experience with palliative and terminal care, the use of recommended work methods from the guideline, communication with partners, self-reported role in palliative care and confidence in providing palliative care. Data were analyzed descriptively, using SPSS.
Results
Each RGP had few patients needing palliative care, and limited experience with terminal care at home. Limited experience challenged RGPs possibilities to maintain knowledge about palliative care. Their clinical approach was not in agreement with the guideline, but most of them saw themselves as central, and were confident in the provision of palliative care. Rural RGPs saw themselves as more central in this work than their urban colleagues.
Conclusions
This study demonstrated low adherence of the RGPs, to the Norwegian guideline for palliative care. Guideline requirements may not correspond with the methods of general practice, making them difficult to adopt. The RGPs seemed to have too few clinical cases over time to maintain skills at a complex and specialized level. Yet, there seems to be a great potential for the RGP, with the inherent specialist skills of the general practitioner, to be a key worker in the palliative care trajectory.
Funder
Norwegian Research Fund for General Practice
Norwegian Committee on Research in General Practice
Norwegian University of Science and Technology.
Publisher
Springer Science and Business Media LLC
Reference58 articles.
1. Helsedirektoratet. Nasjonalt handlingsprogram med retningslinjer for palliasjon i kreftomsorgen. (National action program with guideline for palliative care). Helsedirektoratet (Norwegian Directorate of Healt); 2007.
2. Kreftregisteret (Cancer registry of Norway). 2014 [cited 07.09.2016]. Available from: https://www.kreftregisteret.no/.
3. Neergaard MA, Jensen AB, Sondergaard J, Sokolowski I, Olesen F, Vedsted P. Preference for place-of-death among terminally ill cancer patients in Denmark. Scand J Caring Sci. 2011;25(4):627–36.
4. Collis E, Al-Qurainy R. Care of the dying patient in the community. BMJ. 2013;347:f4085.
5. Gomes B, Calanzani N, Gysels M, Hall S, Higginson IJ. Heterogeneity and changes in preferences for dying at home: a systematic review. BMC Palliat Care. 2013;12:7.
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