我们如何确保专科姑息家庭护理的成功？一项定性研究（ELSAH）从患者、亲属和卫生专业人员的角度确定关键问题。

How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals.

作者信息

Seipp Hannah, Haasenritter Jörg, Hach Michaela, Becker Dorothée, Ulrich Lisa-R, Schütze Dania, Engler Jennifer, Michel Cathrin, Bösner Stefan, Kuss Katrin

机构信息

Department of General Practice and Family Medicine, Philipps-University of Marburg, Marburg, Hessen, Germany.

Professional Association of Specialised Palliative Homecare in Hesse, Wiesbaden, Germany.

出版信息

Palliat Med. 2021 Dec;35(10):1844-1855. doi: 10.1177/02692163211026516. Epub 2021 Jun 25.

DOI:10.1177/02692163211026516

PMID:34169767

Abstract

BACKGROUND

Specialised palliative home-care supports patients with life-limiting diseases in their familiar surroundings. The number of palliative care teams and patients being cared for is increasing worldwide. To assess and improve quality, it is needed to understand, how specialised palliative home-care can be provided successfully. For this purpose we examined the views of all involved stakeholders.

AIM

To identify the issues that patients, their relatives and involved health professionals view as important in ensuring the success of specialised palliative home-care.

DESIGN

We used a qualitative design based on participant observations, interviews and focus groups following the principles of a Grounded Theory approach.

SETTING/PARTICIPANTS: All specialised palliative home-care teams ( = 22) caring for adults in Hesse, Germany, participated. We conducted participant observations ( = 5), and interviewed patients ( = 14), relatives ( = 14) and health professionals working in or collaborating with specialised palliative home-care ( = 30). We also conducted focus groups ( = 4) with health professionals including a member check.

RESULTS

Successful specialised palliative home-care needs to treat complex symptoms, and provide comprehensive care including organisation of care, involving relatives and addressing issues of death and dying. Sense of security for patients and relatives is key to enable care at home. Care delivery preferences include a focus on the quality of relationships, respect for individuality and the facilitation of self-determination.

CONCLUSIONS

Consideration of the identified key issues can help to ensure successful specialised palliative home-care. Knowledge of these should also be considered when researching and assessing quality of care.