The experiences of rural generalist occupational therapists in provision of palliative care in rural, regional, and remote Australia: A phenomenological inquiry

Abstract

Introduction: Access to specialist palliative care in rural and remote Australia is limited, resulting in a reliance on generalist health professionals to provide these services. Although literature exists concerning the experiences of some health professions in providing rural generalist palliative care, little is known about the experiences of occupational therapists who fill these roles. This paper aims to address this gap in knowledge by exploring the experiences of rural generalist occupational therapists in the provision of palliative care in rural, regional, and remote Australia.

Methods: An interpretive phenomenological approach guided this research. Data were collected from eight rural generalist occupational therapists across Australia, using semi-structured, in-depth interviews. Data were thematically analysed to develop a nuanced understanding of lived experience in provision of palliative care.

Consumer and community involvement: Due to the focus of this research on the practice experiences of occupational therapists, consumer and/or community involvement was not undertaken in its design or implementation.

Findings: Three key themes were identified: 'community connections - a double-edged sword'; 'frustrations with structural and contextual factors limiting quality palliative care service provision'; and 'education and support as enablers of professional preparedness for palliative care service provision.' Taken collectively, these findings shed light on a variety of challenges and opportunities associated with rural generalist palliative care occupational therapy practice, as well as clues to their effective management.

Conclusion: Knowledge of rural generalist occupational therapists' experiences can inform workforce development, promote retention of rural occupational therapists, and improve outcomes for dying persons, their families and caregivers. This study offers new insights into challenges and opportunities for rural generalist occupational therapy practice in palliative care and highlights the way in which both, new and existing support structures may be of value in promoting practice capacity and therapist wellbeing.

Plain language summary: It can be hard to get expert support for dying people in areas outside of cities in Australia. Health workers in these areas should be helped to provide good care. In this study, we spoke with some health workers in rural and remote areas who occasionally work with people who are dying. They told us that people in these areas were often helpful in supporting people who are dying because they felt close to them. But they also said that this made caring sadder for health workers because, sometimes, they were close to the people who were dying too. Having too much work, not enough experience and long distances made providing good care extra difficult. The health workers said that getting expert advice or using online teaching could help them improve their practice, but finding the time to do this is hard.