Muligheder og barrierer for udvikling af den kommunale palliative indsats: Evaluering af et aktionsforskningsinspireret projekt

Abstract

Aim This study is based on a project inspired by action research with the aim to elucidate possibilities and barriers for the organizational and professional development of community palliative care services. Background Many people with life-threatening diseases want to stay in their own homes as long as possible. Therefore, community palliative care services are significant. Experience concurrently shows several interdisciplinary and inter-sectorial challenges between professions and different organizations. Method The evaluation consisted of continuous reflections of practice by the involved professionals, an interview study with 21 professionals and a questionnaire survey among 88 professionals and 13 relatives. Results The evaluation showed that the guideline system The Gold Standard Framework and EORTC-QLQ-C15-PAL in combination with more locally-developed interventions, according to the professionals, had improved the community palliative care services. However, the results also showed barriers for improvement and change of practice: such as mainly insufficient management, lack of commitment among some of the professionals to work with the new interventions, insufficient information technology, reorganization, cost-cutting, and differently structured organizations. Conclusion The interventions encouraged the community development palliative care, but also showed that there were barriers for the change process. There is a need for research and development of how to lead and manage change processes and methods of cooperation in community palliative care.