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What does 'complex' mean in palliative care? Triangulating qualitative findings from 3 settings
Emma Carduff1,2, Sarah Johnston3, Catherine Winstanley3
1Marie Curie Hospice, 133 Balornock Road, Glasgow, G21 3US, UK. Emma.Carduff@mariecurie.org.uk.
BMC Palliative Care
|January 6, 2018
Summary
Health professionals perceive complexity in palliative care due to multi-dimensional needs and communication issues. Training can improve confidence and skills in managing complex cases for patients with terminal illnesses.
Area of Science:
- Palliative Care Medicine
- Healthcare Professional Education
Background:
- Defining complex need in palliative care is crucial for distinguishing patient needs.
- Understanding how health professionals perceive complexity is vital for service delivery.
Purpose of the Study:
- To explore health professionals' understanding of complex need in palliative care.
- To identify factors contributing to perceived complexity in different healthcare settings.
Main Methods:
- Qualitative study using semi-structured interviews with 34 health professionals (doctors, nurses, allied health professionals).
- Data collected from primary care, hospital, and hospice settings in the UK.
- Thematic analysis of data followed by a comparative workshop.
Main Results:
- Complexity arises from multi-dimensional needs, comorbidities, intractable symptoms, and psychosocial issues.
- Poor patient-clinician communication exacerbates perceived complexity.
- Generalist professionals reported lacking confidence, skills, and time for palliative care development.
Conclusions:
- Perceived complexity in palliative care stems from patient factors and professional perceptions.
- Lack of confidence, time, and resources contribute to perceived complexity.
- Targeted training in identification, prognostication, and communication can address perceived complexity.