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Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners

Previous research on general practitioners' (GPs') involvement in end‐of‐life care has largely focused on a specific aspect of care or has provided broad overviews that failed to capture individual variations in patient management. This qualitative study aimed to explore Australian GPs...

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Autores principales: Ding, Jinfeng, Licqurish, Sharon, Cook, Angus, Ritson, Dianne, Masarei, Carolyn, Chua, David, Mitchell, Geoffrey, Johnson, Claire E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087779/
https://www.ncbi.nlm.nih.gov/pubmed/35916631
http://dx.doi.org/10.1111/hsc.13931
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author Ding, Jinfeng
Licqurish, Sharon
Cook, Angus
Ritson, Dianne
Masarei, Carolyn
Chua, David
Mitchell, Geoffrey
Johnson, Claire E.
author_facet Ding, Jinfeng
Licqurish, Sharon
Cook, Angus
Ritson, Dianne
Masarei, Carolyn
Chua, David
Mitchell, Geoffrey
Johnson, Claire E.
author_sort Ding, Jinfeng
collection PubMed
description Previous research on general practitioners' (GPs') involvement in end‐of‐life care has largely focused on a specific aspect of care or has provided broad overviews that failed to capture individual variations in patient management. This qualitative study aimed to explore Australian GPs' feedback and reflections on the individual‐level care provided for patients in their last year of life. The findings of the study were drawn from a nation‐wide survey of GPs' experiences in end‐of‐life care. We analysed responses from 63 GPs for 267 of the 272 reported deaths. Factors influencing delivery of optimal end‐of‐life care reported by GPs were categorised into four groups: patient‐related factors, carer‐related factors, interactions between GPs and patients/carer‐related factors and broader health system issues. Each group included both barriers and facilitators. Our study highlighted importance of the emotional dimensions of therapeutic relationships with patients and their family, availability and capacity of family support and smooth communication and continuity of care between GPs and hospitals in delivery of optimal end‐of‐life care. Lack of these facilitators, misconceptions of palliative care and conflicts on implementing care plans among patients and their family tended to impede delivery of such care. On the basis of our findings in the present study and previous literature, we conclude that improved end‐of‐life care in general practice requires comprehensive approaches to supporting both the GP and family to provide care in patients' preferred place, such as enhanced palliative care training and improved availability of external support for GPs, higher levels of hospital‐based services reaching into community settings and broader community‐based resources for families beyond simply the healthcare system.
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spelling pubmed-100877792023-04-12 Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners Ding, Jinfeng Licqurish, Sharon Cook, Angus Ritson, Dianne Masarei, Carolyn Chua, David Mitchell, Geoffrey Johnson, Claire E. Health Soc Care Community Original Articles Previous research on general practitioners' (GPs') involvement in end‐of‐life care has largely focused on a specific aspect of care or has provided broad overviews that failed to capture individual variations in patient management. This qualitative study aimed to explore Australian GPs' feedback and reflections on the individual‐level care provided for patients in their last year of life. The findings of the study were drawn from a nation‐wide survey of GPs' experiences in end‐of‐life care. We analysed responses from 63 GPs for 267 of the 272 reported deaths. Factors influencing delivery of optimal end‐of‐life care reported by GPs were categorised into four groups: patient‐related factors, carer‐related factors, interactions between GPs and patients/carer‐related factors and broader health system issues. Each group included both barriers and facilitators. Our study highlighted importance of the emotional dimensions of therapeutic relationships with patients and their family, availability and capacity of family support and smooth communication and continuity of care between GPs and hospitals in delivery of optimal end‐of‐life care. Lack of these facilitators, misconceptions of palliative care and conflicts on implementing care plans among patients and their family tended to impede delivery of such care. On the basis of our findings in the present study and previous literature, we conclude that improved end‐of‐life care in general practice requires comprehensive approaches to supporting both the GP and family to provide care in patients' preferred place, such as enhanced palliative care training and improved availability of external support for GPs, higher levels of hospital‐based services reaching into community settings and broader community‐based resources for families beyond simply the healthcare system. John Wiley and Sons Inc. 2022-08-02 2022-11 /pmc/articles/PMC10087779/ /pubmed/35916631 http://dx.doi.org/10.1111/hsc.13931 Text en © 2022 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Ding, Jinfeng
Licqurish, Sharon
Cook, Angus
Ritson, Dianne
Masarei, Carolyn
Chua, David
Mitchell, Geoffrey
Johnson, Claire E.
Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title_full Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title_fullStr Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title_full_unstemmed Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title_short Delivery and outcomes of end‐of‐life care in the Australian context: Experiences and reflections of general practitioners
title_sort delivery and outcomes of end‐of‐life care in the australian context: experiences and reflections of general practitioners
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10087779/
https://www.ncbi.nlm.nih.gov/pubmed/35916631
http://dx.doi.org/10.1111/hsc.13931
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