Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Am J Hosp Palliat Care. 2022 Feb;39(2):189-195. doi: 10.1177/10499091211012605. Epub 2021 Apr 26.
Despite some insurance plans now paying for home-based palliative care, recent reports have suggested that insurance coverage for palliative care may be insufficient in expanding patient access to home-based palliative care.
To identify patients' and caregivers' perceived barriers to home-based palliative care and their recommendations for overcoming these barriers.
We conducted a qualitative study using semi-structured individual interviews. Our interview protocol elicited participants' perspectives on home-based palliative care services; positive and negative aspects of the palliative program explanation; and suggestions for improving messaging around home-based palliative care.
SETTING/PARTICIPANTS: Twenty-five participants (patients, proxies, and their caregivers) who were eligible for a randomized controlled trial of home-based palliative care were interviewed by telephone.
Themes related to home-based palliative care referral barriers included reluctance to have home visits, enrollment timing, lack of palliative care knowledge, misconceptions about palliative care, and patients' self-perceived health condition. Themes related to recommendations for overcoming these obstacles included ensuring that palliative care referrals come from healthcare providers or insurance companies and presenting palliative care services more clearly.
Findings reinforce the need for additional palliative care education among patients with serious illness (and their caregivers) and the importance of delivering palliative care information and referrals from trusted sources.
尽管现在有些保险计划已经开始支付家庭姑息治疗费用，但最近的报告表明，姑息治疗的保险覆盖范围可能不足以扩大患者获得家庭姑息治疗的机会。
确定患者和护理人员对家庭姑息治疗的感知障碍，以及他们对克服这些障碍的建议。
我们采用半结构式个体访谈进行了一项定性研究。我们的访谈方案引出了参与者对家庭姑息治疗服务的看法；姑息治疗方案解释的积极和消极方面；以及围绕家庭姑息治疗的信息传递的改进建议。
地点/参与者：对家庭姑息治疗随机对照试验有资格的 25 名参与者（患者、代理人及其护理人员）通过电话接受了访谈。
与家庭姑息治疗转介障碍相关的主题包括不愿接受家访、入组时间、缺乏姑息治疗知识、对姑息治疗的误解以及患者自我感知的健康状况。与克服这些障碍的建议相关的主题包括确保姑息治疗转介来自医疗保健提供者或保险公司，以及更清晰地提供姑息治疗服务。
研究结果强调了在患有严重疾病的患者（及其护理人员）中需要进行更多姑息治疗教育，以及从可信赖的来源传递姑息治疗信息和转介的重要性。
