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

BMC Palliative Care

Research

Irene Hetlevik¹  Bente Prytz Mjølstad²  Anne Fasting³ 

[1] General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, PO Box 8905 MTFS, N-7491, Trondheim, Norway;General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, PO Box 8905 MTFS, N-7491, Trondheim, Norway;Saksvik legekontor, Saxe Viks veg 4, N-7562, Hundhammeren, Norway;General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, PO Box 8905 MTFS, N-7491, Trondheim, Norway;Unit for Palliative Care and Chemotherapy Treatment, Cancer Department, More Og Romsdal Hospital Trust, Kristiansund Hospital, Kristiansund, Norway;

关键词: Palliative care;    Primary care;    Palliative medicine;    General practice;    Advance care planning;    End-of-life care;    Transitions of care;    Norway;   

DOI  :  10.1186/s12904-022-01015-1

 received in 2022-03-16, accepted in 2022-06-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundModern 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.MethodsWe 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.ResultsStrengths 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.ConclusionGPs 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.

【 授权许可】

CC BY   
© The Author(s) 2022. corrected publication 2023

【 图 表 】

Fig. 13