McLaughlin Dorry, Barr Owen, McIlfatrick Sonja, McConkey Roy
School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
Institute of Nursing and Health Research, School of Nursing, University of Ulster, Newtownabbey, UK.
Palliat Med. 2014 Dec;28(10):1213-21. doi: 10.1177/0269216314550373. Epub 2014 Sep 19.
The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature. In response, more partnership practice in end-of-life care is proposed.
This study aimed to develop a best practice model to guide and promote partnership practice between specialist palliative care and intellectual disability services.
A mixed methods research design involving two phases was used, underpinned by a conceptual model for partnership practice.
SETTING/PARTICIPANTS: Phase 1 involved scoping end-of-life care to people with intellectual disability, based on self-completed questionnaires. In all, 47 of 66 (71.2%) services responded. In Phase 2, semi-structured interviews were undertaken with a purposive sample recruited of 30 health and social care professionals working in intellectual disability and palliative care services, who had provided palliative care to someone with intellectual disability. For both phases, data were collected from primary and secondary care in one region of the United Kingdom.
In Phase 1, examples of good practice were apparent. However, partnership practice was infrequent and unmet educational needs were identified. Four themes emerged from the interviews in Phase 2: challenges and issues in end-of-life care, sharing and learning, supporting and empowering and partnership in practice.
Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.
国际文献强调了智障人士难以获得优质姑息治疗的问题。对此,有人提议在临终关怀方面开展更多的合作实践。
本研究旨在开发一种最佳实践模式,以指导和促进专科姑息治疗与智障服务之间的合作实践。
采用了一种混合方法研究设计,包括两个阶段,并以合作实践的概念模型为基础。
地点/参与者:第一阶段基于自我填写的问卷,对智障人士的临终关怀进行了范围界定。66个服务机构中有47个(71.2%)做出了回应。在第二阶段,对30名在智障和姑息治疗服务领域工作、曾为智障人士提供过姑息治疗的健康和社会护理专业人员进行了有目的抽样的半结构化访谈。两个阶段的数据均来自英国一个地区的初级和二级护理机构。
在第一阶段,良好实践的例子很明显。然而,合作实践并不常见,且发现了未满足的教育需求。第二阶段的访谈中出现了四个主题:临终关怀中的挑战和问题、分享与学习、支持与赋权以及实践中的合作。
智障服务和专科姑息治疗之间的联合工作和学习被视为关键和基础。已经开发了一个两个服务机构之间合作实践的框架,该框架可能具有国际适用性,应与临终关怀领域的其他服务机构进行探讨。