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. 2024 Sep 28;14(9):e086557.
doi: 10.1136/bmjopen-2024-086557.

Health professionals' and caregivers' perspectives on improving paramedics' provision of palliative care in Australian communities: a qualitative study

Madeleine Juhrmann  1   2 , Phyllis Butow  3 , Cara Platts  4   5 , Mark Boughey  6   5 , Paul Simpson  7 , Josephine M Clayton  8   2
Affiliations

Health professionals' and caregivers' perspectives on improving paramedics' provision of palliative care in Australian communities: a qualitative study

Madeleine Juhrmann et al. BMJ Open. .

Abstract

Objectives: Paramedics have the potential to make a substantial contribution to community-based palliative care provision. However, they are hindered by a lack of policy and institutional support, as well as targeted education and training. This study aimed to elicit paramedics', palliative care doctors' and nurses', general practitioners', residential aged care nurses' and bereaved families and carers' attitudes and perspectives on how palliative paramedicine can be improved to better suit the needs of community-based patients, their families and carers, and the clinicians involved in delivering the care.

Design: In this qualitative study underpinned by a social constructivist epistemology, semistructured interviews were conducted.

Setting and participants: 50 participants with palliative paramedicine experience, from all jurisdictions of Australia. Participants were interviewed between November 2021 and April 2022.

Results: All participants suggested paramedics play an important adjunct role in the provision of palliative and end-of-life care in home-based settings. Three levels of opportunities for improvement were identified: macrolevel (policy and frameworks; funding and education; accessing medical records and a widening scope); mesolevel (service-level training; interprofessional understanding and communities of practice and community expectations) and microlevel (palliative care subspecialty; debriefing and self-care and partnering with families).

Conclusion: To enhance paramedic capacity to provide palliative care support, improvements targeting systems, services, communities and individuals should be made. This calls for stronger inclusion of paramedicine in interdisciplinary palliative care and greater investment in both the generalist and specialist palliative paramedicine workforce.

Keywords: emergency departments; health workforce; palliative care.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1. Thematic summary of interventions to improve palliative paramedicine practice.
See this image and copyright information in PMC

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References

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