Cargando…
Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework
BACKGROUND: Palliative care provision for persons experiencing homelessness is often poor. A threefold consultation service intervention was expected to increase knowledge of palliative care and multidisciplinary collaboration, and improve palliative care for this population. This intervention compr...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635139/ https://www.ncbi.nlm.nih.gov/pubmed/36329461 http://dx.doi.org/10.1186/s12904-022-01083-3 |
_version_ | 1784824644315906048 |
---|---|
author | Klop, Hanna T. de Veer, Anke J. E. Gootjes, Jaap R. G. Groot, Marieke Rietjens, Judith A. C. Onwuteaka-Philipsen, Bregje D. |
author_facet | Klop, Hanna T. de Veer, Anke J. E. Gootjes, Jaap R. G. Groot, Marieke Rietjens, Judith A. C. Onwuteaka-Philipsen, Bregje D. |
author_sort | Klop, Hanna T. |
collection | PubMed |
description | BACKGROUND: Palliative care provision for persons experiencing homelessness is often poor. A threefold consultation service intervention was expected to increase knowledge of palliative care and multidisciplinary collaboration, and improve palliative care for this population. This intervention comprised: 1) consultation of social service professionals by palliative care specialists and vice versa; 2) multidisciplinary meetings with these professionals; and 3) training and education of these professionals. We aimed to evaluate the implementation process and its barriers and facilitators of this service implemented within social services and healthcare organizations in three Dutch regions. METHODS: A process evaluation using structured questionnaires among consultants, semi-structured individual and group interviews among professionals involved, and (research) diaries. Qualitative data were analysed using thematic analysis. The process evaluation was structured using the Reach, Adoption, Implementation and Maintenance dimensions of the RE-AIM framework. RESULTS: All three regions adopted all three activities of the intervention, with differences between the three regions in the start, timing and frequency. During the 21-month implementation period there were 34 consultations, 22 multidisciplinary meetings and 9 training sessions. The professionals reached were mainly social service professionals. Facilitators for adoption of the service were a perceived need for improving palliative care provision and previous acquaintance with other professionals involved, while professionals’ limited skills in recognizing, discussing and prioritizing palliative care hindered adoption. Implementation was facilitated by a consultant’s expertise in advising professionals and working with persons experiencing homelessness, and hindered by COVID-19 circumstances, staff shortages and lack of knowledge of palliative care in social service facilities. Embedding the service in regular, properly funded meetings was expected to facilitate maintenance, while the limited number of persons involved in this small-scale service was expected to be an obstacle. CONCLUSIONS: A threefold intervention aimed at improving palliative care for persons experiencing homelessness is evaluated as being most usable when tailored to specific regions, with bedside and telephone consultations and a combination of palliative care consultants and teams of social service professionals. It is recommended to further implement this region-tailored intervention with palliative care consultants in the lead, and to raise awareness and to remove fear of palliative care provision. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-022-01083-3. |
format | Online Article Text |
id | pubmed-9635139 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-96351392022-11-05 Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework Klop, Hanna T. de Veer, Anke J. E. Gootjes, Jaap R. G. Groot, Marieke Rietjens, Judith A. C. Onwuteaka-Philipsen, Bregje D. BMC Palliat Care Research BACKGROUND: Palliative care provision for persons experiencing homelessness is often poor. A threefold consultation service intervention was expected to increase knowledge of palliative care and multidisciplinary collaboration, and improve palliative care for this population. This intervention comprised: 1) consultation of social service professionals by palliative care specialists and vice versa; 2) multidisciplinary meetings with these professionals; and 3) training and education of these professionals. We aimed to evaluate the implementation process and its barriers and facilitators of this service implemented within social services and healthcare organizations in three Dutch regions. METHODS: A process evaluation using structured questionnaires among consultants, semi-structured individual and group interviews among professionals involved, and (research) diaries. Qualitative data were analysed using thematic analysis. The process evaluation was structured using the Reach, Adoption, Implementation and Maintenance dimensions of the RE-AIM framework. RESULTS: All three regions adopted all three activities of the intervention, with differences between the three regions in the start, timing and frequency. During the 21-month implementation period there were 34 consultations, 22 multidisciplinary meetings and 9 training sessions. The professionals reached were mainly social service professionals. Facilitators for adoption of the service were a perceived need for improving palliative care provision and previous acquaintance with other professionals involved, while professionals’ limited skills in recognizing, discussing and prioritizing palliative care hindered adoption. Implementation was facilitated by a consultant’s expertise in advising professionals and working with persons experiencing homelessness, and hindered by COVID-19 circumstances, staff shortages and lack of knowledge of palliative care in social service facilities. Embedding the service in regular, properly funded meetings was expected to facilitate maintenance, while the limited number of persons involved in this small-scale service was expected to be an obstacle. CONCLUSIONS: A threefold intervention aimed at improving palliative care for persons experiencing homelessness is evaluated as being most usable when tailored to specific regions, with bedside and telephone consultations and a combination of palliative care consultants and teams of social service professionals. It is recommended to further implement this region-tailored intervention with palliative care consultants in the lead, and to raise awareness and to remove fear of palliative care provision. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-022-01083-3. BioMed Central 2022-11-04 /pmc/articles/PMC9635139/ /pubmed/36329461 http://dx.doi.org/10.1186/s12904-022-01083-3 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 Klop, Hanna T. de Veer, Anke J. E. Gootjes, Jaap R. G. Groot, Marieke Rietjens, Judith A. C. Onwuteaka-Philipsen, Bregje D. Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title | Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title_full | Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title_fullStr | Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title_full_unstemmed | Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title_short | Implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the RE-AIM framework |
title_sort | implementation of a threefold intervention to improve palliative care for persons experiencing homelessness: a process evaluation using the re-aim framework |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9635139/ https://www.ncbi.nlm.nih.gov/pubmed/36329461 http://dx.doi.org/10.1186/s12904-022-01083-3 |
work_keys_str_mv | AT klophannat implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework AT deveerankeje implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework AT gootjesjaaprg implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework AT grootmarieke implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework AT rietjensjudithac implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework AT onwuteakaphilipsenbregjed implementationofathreefoldinterventiontoimprovepalliativecareforpersonsexperiencinghomelessnessaprocessevaluationusingthereaimframework |