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Palliative care by family physicians in the 1990s. Resilience amid reform
F Burge1, P McIntyre, P Twohig
1Dalhousie University, Department of Family Medicine, Abbie J. Lane Building, 8th Floor, 5909 Veterans Memorial Lane, Halifax, NS B3H 2E2.
Objective:
To explore issues family physicians face in providing community-based palliative care to their patients in the context of a changing health care system.
Design:
Focus groups.
Setting:
Small (< 10,000 population), medium-sized (10,000 to 50,000), and large (> 50,000) communities in Nova Scotia.
Participants:
Twenty-five men and women physicians with varying years of practice experience in both solo and group practices.
Method:
A semistructured approach was used, asking physicians to reflect on recent palliative care experiences in order to explore issues of care.
Main Findings:
Five themes emerged from the discussions: resources needed, availability of family support, time and money supporting physicians' activities, symptom control for patients, and physicians' emotional reactions to caring for dying patients.
Conclusion:
With downsizing of hospitals and greater emphasis on community-based care, the issues identified in this study will need attention, particularly in designing an integrated service delivery model for palliative care.