Shalev Ariel, Phongtankuel Veerawat, Lampa Katherine, Reid M C, Eiss Brian M, Bhatia Sonica, Adelman Ronald D
1 Weill Cornell Medical College, New York, NY, USA.
2 The Mount Sinai Hospital, Brookdale Department of Geriatrics and Palliative Medicine, New York, NY, USA.
Am J Hosp Palliat Care. 2018 Apr;35(4):684-689. doi: 10.1177/1049909117734845. Epub 2017 Oct 8.
The transition into home hospice care is often a critical time in a patient's medical care. Studies have shown patients and caregivers desire continuity with their physicians at the end of life (EoL). However, it is unclear what roles primary care physicians (PCPs) play and what challenges they face caring for patients transitioning into home hospice care.
To understand PCPs' experiences, challenges, and preferences when their patients transition to home hospice care.
Nineteen semi-structured phone interviews with PCPs were conducted. Study data were analyzed using standard qualitative methods.
Participants included PCPs from 3 academic group practices in New York City. Measured: Physician recordings were transcribed and analyzed using content analysis.
Most PCPs noted that there was a discrepancy between their actual role and ideal role when their patients transitioned to home hospice care. Primary care physicians expressed a desire to maintain continuity, provide psychosocial support, and collaborate actively with the hospice team. Better establishment of roles, more frequent communication with the hospice team, and use of technology to communicate with patients were mentioned as possible ways to help PCPs achieve their ideal role caring for their patients receiving home hospice care.
Primary care physicians expressed varying degrees of involvement during a patient's transition to home hospice care, but many desired to be more involved in their patient's care. As with patients, physicians desire to maintain continuity with their patients at the EoL and solutions to improve communication between PCPs, hospice providers, and patients need to be explored.
向家庭临终关怀护理的过渡通常是患者医疗护理中的关键时期。研究表明，患者及其护理人员希望在生命末期（EoL）与他们的医生保持连续性。然而，初级保健医生（PCP）在照顾过渡到家庭临终关怀护理的患者时所扮演的角色以及面临的挑战尚不清楚。
了解初级保健医生在其患者过渡到家庭临终关怀护理时的经历、挑战和偏好。
对初级保健医生进行了19次半结构化电话访谈。使用标准定性方法对研究数据进行分析。
参与者包括来自纽约市3个学术团体诊所的初级保健医生。测量：对医生的录音进行转录并使用内容分析法进行分析。
大多数初级保健医生指出，当他们的患者过渡到家庭临终关怀护理时，他们的实际角色与理想角色之间存在差异。初级保健医生表示希望保持连续性、提供心理社会支持并与临终关怀团队积极合作。更好地明确角色、与临终关怀团队更频繁地沟通以及使用技术与患者沟通被提及为帮助初级保健医生实现其照顾接受家庭临终关怀护理患者的理想角色的可能方法。
初级保健医生在患者过渡到家庭临终关怀护理期间表示参与程度各不相同，但许多人希望更多地参与患者护理。与患者一样，医生希望在生命末期与患者保持连续性，需要探索改善初级保健医生、临终关怀提供者和患者之间沟通的解决方案。
