Jabbari Hossein, Azami-Aghdash Saber, Piri Reza, Naghavi-Behzad Mohammad, Sullman Mark Jm, Safiri Saeid
Department of Community Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
J Pain Res. 2018 Dec 18;12:17-27. doi: 10.2147/JPR.S178103. eCollection 2019.
The provision of palliative end-of-life care (P/EOLc) for patients, wherever they live, is an increasingly important service, particularly given the increasing rates of cancer and other life-threatening diseases in Iran. However, unfortunately, those living in the rural areas of Iran are greatly disadvantaged with respect to this type of care. Therefore, the present study explored the feasibility of organizing P/EOLc in the rural areas of Iran.
In this qualitative study, two focus group (FG) discussions were held in Tabriz (Iran) with rural family physicians (FPs, n=23) and key P/EOLc stakeholders (n=13). The FG sessions were recorded, transcribed, and the transcriptions checked by participants before the data were subjected to content analysis.
While most FPs indicated that they did not have sufficient involvement in providing P/EOLc, they emphasized the necessity of providing P/EOLc through four main themes and 25 subthemes. The four main themes were labeled as "structures and procedures," "health care provider teams," "obstacles," and "strategies or solutions." Furthermore, according to the main themes and subthemes identified here, the key stakeholders believed that the Iranian health system and the FPs' team have the potential to provide P/EOLc services in rural areas.
The most feasible strategy for providing P/EOLc in Iranian rural areas would be to use the current health care framework and base the process around the FP.
无论患者居住在何处，为其提供姑息性临终关怀（P/EOLc）都是一项日益重要的服务，特别是考虑到伊朗癌症和其他危及生命疾病的发病率不断上升。然而，不幸的是，伊朗农村地区的居民在这类护理方面处于极大的劣势。因此，本研究探讨了在伊朗农村地区组织P/EOLc的可行性。
在这项定性研究中，在大不里士（伊朗）与农村家庭医生（FPs，n = 23）和P/EOLc关键利益相关者（n = 13）举行了两次焦点小组（FG）讨论。FG会议进行了记录、转录，并且在对数据进行内容分析之前，由参与者检查转录内容。
虽然大多数家庭医生表示他们在提供P/EOLc方面没有足够的参与，但他们通过四个主要主题和25个子主题强调了提供P/EOLc的必要性。这四个主要主题被标记为“结构和程序”、“医疗保健提供者团队”、“障碍”和“策略或解决方案”。此外，根据此处确定的主要主题和子主题，关键利益相关者认为伊朗卫生系统和家庭医生团队有潜力在农村地区提供P/EOLc服务。
在伊朗农村地区提供P/EOLc最可行的策略是利用当前的医疗保健框架，并以家庭医生为核心开展这一过程。
