Changes in professionals’ beliefs following a palliative care implementation programme at a surgical department: a qualitative evaluation

BMC Palliative Care

Research Article

Joakim Öhlén¹  Helena Leveälahti²  Janet Winnhed³  Staffan Lundström⁴  Pia Hahne⁵ 

[1] Institute of Health and Care Sciences and University of Gothenburg Center for Person-Centered Care, Salgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35, Stockholm, Sweden;Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35, Stockholm, Sweden;ASIH Praktikertjänst Västerort N.Ä.R.A, Vällingby, Sweden;Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35, Stockholm, Sweden;Department of Oncology-Pathology Karolinska Institutet, Stockholm, Sweden;Stockholms Sjukhem Foundation, Mariebergsgatan 22, 112 35, Stockholm, Sweden;Ersta Sköndal Bräcke University College, Box 111 89, -100 61, Stockholm, SE, Sweden;

关键词: Focus groups;    General surgery;    Health plan implementation;    Palliative care;    Palliative medicine;    Patient care team;    Qualitative research;   

DOI  :  10.1186/s12904-017-0262-4

 received in 2016-11-23, accepted in 2017-12-05,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundOne ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to implement palliative care. The aim of this study is to evaluate how the implementation of palliative care, using a combination of integration and consultation strategies, can change beliefs regarding palliative care among professionals in a surgical department.MethodIn order to explore professionals’ experiential outcome of an educational implementation strategy, a before-after qualitative design was used. The study was based on three focus group discussions. Two discussions were conducted before introducing the implementation strategy and one was conducted after. The participants consisted of five nurses and two specialist surgeons from a surgical department in Sweden. The focus group discussions revealed a variety of different attitudes and beliefs, which were analysed using qualitative systematic text condensation.ResultsBeliefs regarding palliative care were identified in seven areas; the importance of palliative care, working methods in palliative care, team collaboration in palliative care, collegial support, discussions about diagnosis, symptoms at the end of life, and families of patients in palliative care. Changes in beliefs were seen in all areas except one: team collaboration in palliative care.ConclusionIt is possible to change the beliefs of health care professionals in a surgical department regarding palliative care through the implementation of palliative knowledge. Beliefs were changed from an individual to a collective development where the group initiated a shared palliative working method. The changes observed were palliative care being described as more complex and participants differentiating between surgical care and palliative care.

【 授权许可】

CC BY   
© The Author(s). 2017