General Practitioners' Attitudes to Palliative Care: A Western Australian Rural Perspective

O’Connor, Moira; Lee-Steere, Richelle

doi:10.1089/jpm.2006.9.1271

Cited by 37 publications

(98 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…finding from a qualitative study by the first author of this paper was that GPs found dealing with family members of palliative care patients to be extremely stressful. 34 One difficulty that emerged strongly was the need to 'juggle' the time constraints of running a busy business with the need to be compassionate, and this was particularly challenging after the patient had died and the bereaved family member wanted to talk. This juggling and the need to change focus are certainly not particular to community pharmacists; research with health care professionals, looking at eliciting and responding to emotional cues, highlights strategies for prioritizing and supporting patients and carers in busy health care settings.…”

Section: Discussionmentioning

confidence: 99%

Exploring the community pharmacist's role in palliative care: Focusing on the person not just the prescription

O’Connor

Fisher

French

et al. 2011

Patient Education and Counseling

View full text Add to dashboard Cite

ObjectivesChanges in health care provision have led to an emphasis on providing end of life care within the home. Community pharmacists are well positioned to provide services to communitybased palliative care patients and carers. MethodsA multiple qualitative case study design was adopted. A total of 16 focus groups and 19 interviews with pharmacists, nurses, general practitioners and carers were undertaken across metropolitan and regional settings in Western Australia, New South Wales, Queensland and Victoria. Data were analysed thematically using a framework that allowed similarities and differences across stakeholder groups and locations to be examined and compared. ResultsThree main themes emerged: Effective communication; Challenges to effective communication; and: Towards best practice, which comprised two themes: Community pharmacists' skills and Community pharmacists' needs. DiscussionA key component of the provision of palliative care was having effective communication skills. Although community pharmacists saw an opportunity to provide interpersonal support, they suggested that they would need to develop better communication skills to fulfil this role. ConclusionThere is clear need for continuing professional development in this area -particularly in communicating effectively and managing strong emotions. Practice implicationsCommunity pharmacists are willing to support palliative care patients and carers but need education, support and resources. Words: 203Key words: community pharmacists, palliative care, focus groups, effective communication, qualitative research 3 Background and objectivesSince the World Health Organisation 1 proposed that primary health should be at the forefront of health systems, patient care has increasingly been moved from hospital to the home. 2 This changing pattern of health care provision has led to an emphasis on providing care in the community to people at the end of life, 3 acknowledging that people prefer to die with the support of family and friends. 4 Achieving a death at home for a palliative care patient is dependent on a range of factors including the availability of skilled support from community based health professionals. 5-7The provision of this skilled support from health care professionals for community based palliative care, however, is complicated by unmet demand for General Practitioner (GP)services and an increasing number of patients with chronic diseases and complex care needs. 8Additionally an ageing population 9 will result in an increased number of people with chronic and/or life-threatening diseases and, consequently, the numbers of patients requiring palliative care. The involvement of community pharmacists in the provision of community based palliative care would seem an appropriate way of alleviating these challenges and supporting end-of-life care in the home.Although not forming the basis of their substantive work, community pharmacists are wellsuited to respond to the palliative care needs of clients, especially as they often have a...

show abstract

Section: Discussionmentioning

confidence: 99%

Exploring the community pharmacist's role in palliative care: Focusing on the person not just the prescription

O’Connor

Fisher

French

et al. 2011

Patient Education and Counseling

View full text Add to dashboard Cite

show abstract

“…(24) In many countries, the multidisciplinary care team also has a responsibility to plan together for access to palliative care. (25,26) Factors related to the practice styles of medical and allied health professionals may facilitate referral, or lead to referral delays. (27,28) Despite their gate-keeping role, 78% of doctors in one US study felt that palliative care services were underutilised.…”

Section: Patient and Family-related Issuesmentioning

confidence: 99%

“…Difficulties in communicating prognoses with patients and families have been reported in other studies. (9,26) The ability to communicate honestly and openly in regards to prognosis, end-of-life issues, and information about PC is an important aspect of access to PC services. (24) A survey of US doctors revealed they tended to be optimistic regarding prognosis, especially where the doctors perceived their patients as optimistic regarding the outcome of treatment.…”

Section: Patient and Family-related Issuesmentioning

confidence: 99%

Barriers to accessing palliative care: A review of the literature

Love

Liversage

2013

Progress in Palliative Care

View full text Add to dashboard Cite

The aim was to review factors affecting patients' access to palliative care. First, the benefits of palliative care for comprehensive care of patients and their families are identified. Despite these benefits, universal standards for access are lacking and referral typically occurs later than is recommended, limiting access to best practice care. Factors relating to access are reviewed in detail. They are grouped conceptually, combining those related to organisational factors, patient and family-related issues, which include characteristics of patients, preferences for curative care, and willingness to discuss and participate in palliative care, and factors attributed to physicians and health professionals, such as communication styles, sense of efficacy, perceptions of patient readiness, and knowledge of palliative care. Despite the accumulated evidence, the existing studies share methodological weaknesses, which are (1) Yet referrals to PC can still be untimely, poorly managed, or delayed. An earlier review of the literature has identified the problems and issues associated with accessing PC.(2) The aim of this paper is to review the literature published in the decade since, addressing factors associated with access to PC services and to suggest aspects of access to PC requiring further investigation. Referral to palliative careMany studies have demonstrated that earlier access to palliative care may have positive benefits, addressing issues such as anticipatory grief and loss throughout the trajectory, facilitating improved symptom management, improved mood, and overall quality of life. (3,4) Despite the demonstrated benefits, PC use is often less than optimal and opportunities are frequently missed. Table 1.Insert Table 1 about here Factors affecting access to palliative care servicesIn order to conceptualise the many interrelated factors that have been identified as affecting access to PC services, a theoretical model was devised (Figure 1). Patients are considered as part of a family system, including carers and other family members. Health care teams are spearheaded by treating physicians and are part of health organisations.Communication factors between patients and families and health care teams create the foundation on which relationships are formed. There is a broader context: the wider health care system and social and cultural factors are important influences on access to PC services.

show abstract

“…Similarly, in a recent survey of nursing homes in the United States, 63% of homes reported being dissatisfied with the training of staff on death and dying (Moss, Braunschwieg, & Rubinstein, 2002). In a recent Australian study of general practitioners' attitudes to palliative care, the general practitioners articulated a strong desire for professional development related to bereavement support (O'Connor & Lee-Steere, 2006). These studies and reviews highlight that the grief education of health providers is overlooked on the whole, and when it does exist, it is narrow in focus.…”

Section: Grief Educationmentioning

confidence: 99%

The Fundamental Paradox in the Grief Literature: A Critical Reflection

Breen

O’Connor

2007

Omega (Westport)

Self Cite

View full text Add to dashboard Cite

A key theme in the bereavement literature is the recognition that every grief experience is unique and dependent on many variables, such as the circumstances of the death, characteristics of the bereaved individual, their relationship with the deceased, the provision and availability of support, and a myriad of sociocultural factors. Concurrently, there are corresponding efforts to define "normal" grief and delineate it from "complicated" grief experiences. The discord between these two potentially opposing statements remains a paradox evident within the three major tensions within the thanatological literature-the dominance of grief theories, the medicalization of grief, and the efficacy of grief interventions. Three recommendations for moving beyond the paradox are discussed-the provision of improved grief education for service providers, the bereaved, and the wider community; the conduct of research that emphasizes the context of grief and is relevant to service provision; and the examination of current grief interventions.A clear and consistent theme within the thanatological literature is the assertion that the grief experience is very much affected and influenced by a myriad of variables and the interactions between these variables. Various key reviews (e.g., Center for the Advancement

show abstract

General Practitioners' Attitudes to Palliative Care: A Western Australian Rural Perspective

Abstract: Education and training for rural GPs needs to be relevant to the local context and needs to focus on emotions and beliefs.

Cited by 37 publications

References 36 publications

Exploring the community pharmacist's role in palliative care: Focusing on the person not just the prescription

Exploring the community pharmacist's role in palliative care: Focusing on the person not just the prescription

Barriers to accessing palliative care: A review of the literature

The Fundamental Paradox in the Grief Literature: A Critical Reflection

Contact Info

Product

Resources

About