General Practitioner, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
VUB, Belgium.
Palliat Med. 2021 Feb;35(2):355-366. doi: 10.1177/0269216320968741. Epub 2020 Oct 30.
Continuity of care is challenging when transferring patients across palliative care settings. These transfers are common due to the complexity of palliative care, which has increased significantly since the advent of palliative care services. It is unclear how palliative care services and professionals currently collaborate and communicate to ensure the continuity of care across settings, and how patient and family members are involved.
To explore healthcare professionals' experiences regarding the communicative aspects of inter-professional collaboration and the involvement of patient and family members.
Qualitative design, including focus group discussions.
SETTING/PARTICIPANTS: The study focused on one palliative care network in Belgium and involved all palliative care settings: hospital, hospital's palliative care unit, home care, nursing home. Nine group discussions were conducted, with diverse professionals ( = 53) from different care settings.
Timely and effective inter-professional information exchange was considered fundamental. A perceived barrier for interprofessional collaboration was the lack of a shared electronic health record. Efficiency regarding multidisciplinary team meetings and inter-professional communication were subject to improvement.A striking study finding was the perceived insufficient open communication of specialists towards patients and the lack of shared decision making. This not only hampered advance care planning discussions and early integration of palliative home care, but also the functioning of other professionals.
From the perspective of the integrated care framework, several areas of improvement on different levels of care and collaboration are identified. Support from policymakers and researchers is required to achieve integrated palliative care in regional networks.
在姑息治疗环境之间转移患者时，连续性护理具有挑战性。由于姑息治疗的复杂性增加，这些转移很常见，自姑息治疗服务出现以来，这种复杂性显著增加。目前尚不清楚姑息治疗服务和专业人员如何协作和沟通，以确保在不同环境下的护理连续性，以及患者和家属如何参与。
探讨医疗保健专业人员在跨专业协作的沟通方面的经验，以及患者和家属的参与情况。
定性设计，包括焦点小组讨论。
地点/参与者：该研究集中在比利时的一个姑息治疗网络，涉及所有姑息治疗环境：医院、医院姑息治疗病房、家庭护理、养老院。进行了 9 次小组讨论，参与者来自不同护理环境的不同专业人员（=53 人）。
及时有效的跨专业信息交流被认为是至关重要的。缺乏共享的电子健康记录被认为是跨专业协作的障碍。多学科团队会议和跨专业沟通的效率有待提高。一个引人注目的研究发现是，专业人员对患者的沟通不够开放，缺乏共同决策。这不仅阻碍了预先护理计划的讨论和姑息性家庭护理的早期整合，也阻碍了其他专业人员的工作。
从综合护理框架的角度出发，确定了在不同护理和协作层面上需要改进的几个领域。需要政策制定者和研究人员的支持，以在区域网络中实现综合姑息治疗。
