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Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study

BACKGROUND: Modern palliative care focuses on enabling patients to spend their remaining time at home, and dying comfortably at home, for those patients who want it. Compared to many European countries, few die at home in Norway. General practitioners’ (GPs’) involvement in palliative care may incre...

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Autores principales: Fasting, Anne, Hetlevik, Irene, Mjølstad, Bente Prytz
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277777/
https://www.ncbi.nlm.nih.gov/pubmed/35820894
http://dx.doi.org/10.1186/s12904-022-01015-1
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author Fasting, Anne
Hetlevik, Irene
Mjølstad, Bente Prytz
author_facet Fasting, Anne
Hetlevik, Irene
Mjølstad, Bente Prytz
author_sort Fasting, Anne
collection PubMed
description BACKGROUND: Modern palliative care focuses on enabling patients to spend their remaining time at home, and dying comfortably at home, for those patients who want it. Compared to many European countries, few die at home in Norway. General practitioners’ (GPs’) involvement in palliative care may increase patients’ time at home and achievements of home death. Norwegian GPs are perceived as missing in this work. The aim of this study is to explore GPs’ experiences in palliative care regarding their involvement in this work, how they define their role, and what they think they realistically can contribute towards palliative patients. METHODS: We performed focus group interviews with GPs, following a semi-structured interview guide. We included four focus groups with a total of 25 GPs. Interviews were recorded and transcribed verbatim. We performed qualitative analysis on these interviews, inspired by interpretative phenomenological analysis. RESULTS: Strengths of the GP in the provision of palliative care consisted of characteristics of general practice and skills they relied on, such as general medical knowledge, being coordinator of care, and having a personal and longitudinal knowledge of the patient and a family perspective. They generally had positive attitudes but differing views about their formal role, which was described along three positions towards palliative care: the highly involved, the weakly involved, and the uninvolved GP. CONCLUSION: GPs have evident strengths that could be important in the provision of palliative care. They rely on general medical knowledge and need specialist support. They had no consensus about their role in palliative care. Multiple factors interact in complex ways to determine how the GPs perceive their role and how involved they are in palliative care. GPs may possess skills and knowledge complementary to the specialized skills of palliative care team physicians. Specialized teams with extensive outreach activities should be aware of the potential they have for both enabling and deskilling GPs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-022-01015-1.
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spelling pubmed-92777772022-07-14 Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study Fasting, Anne Hetlevik, Irene Mjølstad, Bente Prytz BMC Palliat Care Research BACKGROUND: Modern palliative care focuses on enabling patients to spend their remaining time at home, and dying comfortably at home, for those patients who want it. Compared to many European countries, few die at home in Norway. General practitioners’ (GPs’) involvement in palliative care may increase patients’ time at home and achievements of home death. Norwegian GPs are perceived as missing in this work. The aim of this study is to explore GPs’ experiences in palliative care regarding their involvement in this work, how they define their role, and what they think they realistically can contribute towards palliative patients. METHODS: We performed focus group interviews with GPs, following a semi-structured interview guide. We included four focus groups with a total of 25 GPs. Interviews were recorded and transcribed verbatim. We performed qualitative analysis on these interviews, inspired by interpretative phenomenological analysis. RESULTS: Strengths of the GP in the provision of palliative care consisted of characteristics of general practice and skills they relied on, such as general medical knowledge, being coordinator of care, and having a personal and longitudinal knowledge of the patient and a family perspective. They generally had positive attitudes but differing views about their formal role, which was described along three positions towards palliative care: the highly involved, the weakly involved, and the uninvolved GP. CONCLUSION: GPs have evident strengths that could be important in the provision of palliative care. They rely on general medical knowledge and need specialist support. They had no consensus about their role in palliative care. Multiple factors interact in complex ways to determine how the GPs perceive their role and how involved they are in palliative care. GPs may possess skills and knowledge complementary to the specialized skills of palliative care team physicians. Specialized teams with extensive outreach activities should be aware of the potential they have for both enabling and deskilling GPs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-022-01015-1. BioMed Central 2022-07-12 /pmc/articles/PMC9277777/ /pubmed/35820894 http://dx.doi.org/10.1186/s12904-022-01015-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Fasting, Anne
Hetlevik, Irene
Mjølstad, Bente Prytz
Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title_full Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title_fullStr Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title_full_unstemmed Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title_short Finding their place – general practitioners' experiences with palliative care—a Norwegian qualitative study
title_sort finding their place – general practitioners' experiences with palliative care—a norwegian qualitative study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277777/
https://www.ncbi.nlm.nih.gov/pubmed/35820894
http://dx.doi.org/10.1186/s12904-022-01015-1
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