Tedder Tara, Elliott Lydia, Lewis Karen
MS(N) Program, Western Carolina University, Asheville, North Carolina.
J Am Assoc Nurse Pract. 2017 Jun;29(6):356-362. doi: 10.1002/2327-6924.12475. Epub 2017 May 30.
The aim of this literature review is to explore barriers and potential solutions related to hospice (HC) and palliative care (PC) services among rural residents. Although the healthcare system is continually advancing, healthcare providers may not be optimizing HC and PC referrals for the growing rural population who underutilize these services. Suggested methods to close the utilization gap between HC and PC services among rural patients appear feasible, but universal effectiveness cannot be determined.
An integrative literature review was conducted to evaluate diverse sources of literature. An electronic literature search was carried out using databases MEDLINE, CINAHL, Cochrane, PsycINFO, and Pubmed. The search was limited to English only, full text, peer reviewed, and published between 2010 and 2016. Search terms included rural, hospice, palliative, care access, and barriers.
There are several barriers that interrelate to decreased utilization of PC and HC for rural populations and there are many options for overcoming them to equalize care.
Although advances to the general healthcare system are expediently rising, the rural patient population seems to fall short of these important life-changing services, especially in the realm of PC/HC. Beginning in primary care, this patient population can be affected and included in a positive manner.
本综述旨在探究农村居民在临终关怀（HC）和姑息治疗（PC）服务方面所面临的障碍及潜在解决方案。尽管医疗体系在持续进步，但对于日益增长却未充分利用这些服务的农村人口，医疗服务提供者可能并未优化HC和PC的转诊。在农村患者中缩小HC和PC服务利用差距的建议方法看似可行，但无法确定其普遍有效性。
进行了一项综合性文献综述以评估多种文献来源。使用MEDLINE、CINAHL、Cochrane、PsycINFO和Pubmed数据库进行电子文献检索。检索仅限于英文、全文、经过同行评审且发表于2010年至2016年之间的文献。检索词包括农村、临终关怀、姑息治疗、医疗服务可及性和障碍。
农村人口对PC和HC利用率降低存在多种相互关联的障碍，且有许多克服这些障碍以实现医疗公平的选择。
尽管普通医疗体系的进步迅速，但农村患者群体似乎未能充分获得这些重要的改变生活的服务，尤其是在PC/HC领域。从初级保健开始，这一患者群体能够受到积极影响并被纳入其中。
