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. 2018 Nov 8;18(1):841.
doi: 10.1186/s12913-018-3644-2.

Experiences of Dutch general practitioners and district nurses with involving care services and facilities in palliative care: a mixed methods study

Ian Koper  1 , H Roeline W Pasman  2 , Bregje D Onwuteaka-Philipsen  2
Affiliations

Experiences of Dutch general practitioners and district nurses with involving care services and facilities in palliative care: a mixed methods study

Ian Koper et al. BMC Health Serv Res. .

Abstract

Background: Generals practitioners (GPs) and district nurses (DNs) play a leading role in providing palliative care at home. Many services and facilities are available to support them in providing this complex care. This study aimed to examine the extent to which GPs and DNs involve these services, what their experiences are, and how involvement of these services and facilities can be improved.

Methods: Sequential mixed methods consisting of an online questionnaire with structured and open questions completed by 108 GPs and 258 DNs, followed by three homogenous online focus groups with 8 GPs and 19 DNs, analyzed through open coding.

Results: Most GPs reported that they sometimes or often involved palliative home care teams (99%), hospices (94%), and palliative care consultation services (93%). Most DNs reported sometimes or often involving volunteers (90%), hospices (88%), and spiritual caregivers (80%). The least involved services and facilities were psychologists and psychiatrists (51% and 50%) and social welfare (44% and 57%). Main reason for not involving services and facilities was 'not needing' them. If they had used them, most GPs and DNs (68-93%) reported solely positive experiences. Hardly anyone (0-3%) reported solely negative experiences with any of the services and the facilities. GPs and DNs suggested improvements in three areas: (1) establishment of local centers giving information on available services and facilities, (2) presentation of services and facilities in local multidisciplinary meetings, and (3) support organizations to proactively offer their facilities and services.

Conclusion: Psychological, social, and spiritual services are involved less often, suggesting that the classic care model, which focuses strongly on somatic issues, is still well entrenched. More familiarity with services that can provide additional care in these areas, regarding their availability and their added value, could improve the quality of life for patients and relatives at the end of life.

Keywords: Palliative care; Primary care; Utilization of services.

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Conflict of interest statement

Ethics approval and consent to participate

The Medical Ethics Committee of the VUmc approved this study beforehand (METc VUmc 2016.320). The purpose and content of the survey, as well as the option to pause or stop participation at any time, were explained with the invitation. Informed consent was assumed upon participation in the survey.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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