Rehabilitation in palliative care: a qualitative study of team professionals

Abstract

ObjectivesThere has been a recent drive to embed rehabilitation within palliative care. The concept of rehabilitative palliative care has been advocated to help patients preserve function and independence, through greater patient enablement and self-management. Such an approach requires engagement from all members of the palliative care team. There is a lack of understanding of such viewpoints. The objective of this research was to explore hospice-based palliative care professionals’ understanding and perceptions of rehabilitation.MethodsQualitative semi-structured interviews were conducted. Eighteen hospice-based healthcare professionals were recruited from a hospice in central Scotland. Interviews were audio-recorded, transcribed and thematically analysed.ResultsOverall, participants clearly articulated the underlying values and benefits of rehabilitative palliative care. Emphasis was placed on ensuring that rehabilitation was appropriately tailored to each individual patient. There was more ambiguity regarding the pragmatic implementation of rehabilitative palliative care, with a number of barriers and facilitators identified.ConclusionsThe findings suggest that hospice-based palliative care professionals would be receptive to further implementation of rehabilitative palliative care. A lack of conceptual clarity among palliative care professionals may be a barrier to the effective implementation of rehabilitative palliative care. At an organisational level, this would require clarification of the approach, and additional training involving all members of the multidisciplinary team.

Physiotherapy in palliative medicine: patient and caregiver wellness

“…We already demonstrated significant improvement in functional outcomes, as well as symptoms’ burden that probably contributed to the improvement of the results evaluated in this analysis 25. As a matter of fact, patients experienced a decrease in psychoemotional stress.…”

“…For these reasons, there are scarce data of real-life effectiveness in daily clinical practice scenarios. As a matter of fact, there are still many concerns about the usefulness of these therapies in the setting of a standard programme of palliative care, mainly with doubts of considering them futile or even an oxymoron 13 25–27…”

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The Experiences of People With Advanced Cancer and Professionals Participating in a Program With Focus on Rehabilitation and Palliative Care

“…Different terms are in use to refer to the integration of palliation and rehabilitation, for example, palliative rehabilitation (Nottelmann et al, 2019) and rehabilitative palliative care (Harding et al, 2019). However, this study does not address a theoretical clarification rather to understand how it is possible to work with these perspectives into practice.…”

“…Patients may need both types of services as well as a need for increased consistency between them. However, it may be difficult conceptually and in practice to separate the two disciplines and a lack of conceptual clarity among professionals is a barrier to the effective implementation of rehabilitative palliative care (Harding et al, 2019; Thuesen & Timm. 2014).…”