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Terminal care at home: perspective from general practice.

A Haines, A Booroff

    British Medical Journal (Clinical Research Ed.)
    |April 19, 1986
    PubMed
    Summary

    General practitioners face significant challenges in managing terminally ill patients at home, particularly pain control and emotional distress. Enhanced training and support services are crucial for improving end-of-life care.

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    Area of Science:

    • Palliative Care
    • General Practice
    • Healthcare Services Research

    Background:

    • Home-based care for terminally ill patients presents unique challenges for general practitioners (GPs).
    • Understanding GPs' needs for training and support is vital for optimizing end-of-life care.
    • Existing support structures may not adequately meet the demands of terminal illness management.

    Purpose of the Study:

    • To identify problems encountered by GPs in providing home-based care for terminally ill patients.
    • To assess GPs' perceived needs for enhanced training and support services.
    • To inform improvements in palliative care delivery and GP education.

    Main Methods:

    • A questionnaire survey was distributed to general practitioners in North West London.
    • The survey collected data on challenges in patient care, symptom management, and support service utilization.
    • Response rate was 73% (196/268 doctors).

    Main Results:

    • 32% of GPs frequently struggled with pain control in terminally ill patients.
    • 45% of GPs experienced difficulties managing emotional distress in patients or their families.
    • 20-30% reported issues with inadequate support services, poor communication, and patient admission challenges.
    • Approximately 50% desired more training in pain/symptom management and bereavement counseling.
    • 40% sought communication skills training, and 75% requested increased home nursing support.

    Conclusions:

    • GPs require improved training in symptom management, communication, and emotional support for terminally ill patients.
    • Enhanced and better-coordinated support services, including home nursing, are essential.
    • Addressing these needs can significantly improve the quality of palliative care provided at home.

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