Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
BMC Palliat Care. 2023 Sep 5;22(1):128. doi: 10.1186/s12904-023-01252-y.
The diversity of the population is associated with different needs and expectations towards palliative and hospice care. Current approaches available in Germany generally fall short in addressing the role of diversity and intersectionality in this health care setting and healthcare facilities struggle with organizational difficulties and missing information on how to implement corresponding diversity-sensitive measures. The present study aims to develop a hands-on manual that enables providers of hospice and palliative care to implement measures and strategies for diversity-sensitive care, while taking into account the perspective of healthcare users and explicitly including vulnerable and minority patient groups.
A participatory approach is used to co-create the aforementioned manual using an explanatory sequential mixed-methods design. First, based on a systematic analysis of existing measures, an initial draft of the manual will be developed. Subsequently, an online survey will be conducted among all hospice and palliative care providers in Germany (n = 2,823). Based on the results of the survey, 12 to 15 qualitative problem-centered interviews will be conducted with employees of selected providers who took part in the survey. Results of the survey and the qualitative interviews will be integrated and analyzed. In parallel to the development and research process, a comprehensive dissemination strategy will be developed.
The manual will assist providers of palliative and hospice care in determining goals, needs, and available resources in order to utilize patient-centered and diversity-sensitive measures to meet a wide range of expectations. It can also be informative for providers in other countries. The participatory co-development approach ensures the practical relevance of the manual, while the mixed-methods design allows for targeted input on the manual's usability, acceptance, and viability as a supportive tool.
人口的多样性与人们对姑息治疗和临终关怀的不同需求和期望有关。德国目前提供的方法通常无法解决这一医疗保健领域多样性和交叉性问题，医疗机构在组织上也存在困难，并且缺乏实施相应的多样性敏感措施的信息。本研究旨在制定一份实践手册，使姑息治疗和临终关怀的提供者能够实施多样性敏感护理措施和策略，同时考虑到医疗保健用户的观点，并明确纳入弱势和少数族裔患者群体。
采用参与式方法，使用解释性顺序混合方法设计来共同创建上述手册。首先，根据对现有措施的系统分析，制定手册的初始草案。随后，将对德国所有姑息治疗和临终关怀提供者（n=2823）进行在线调查。根据调查结果，将与参与调查的选定提供者的员工进行 12 至 15 次以问题为中心的定性访谈。调查和定性访谈的结果将进行整合和分析。在手册的开发和研究过程中，将同时制定全面的传播策略。
该手册将帮助姑息治疗和临终关怀的提供者确定目标、需求和可用资源，以便利用以患者为中心和多样性敏感的措施来满足广泛的期望。它也可以为其他国家的提供者提供信息。参与式共同开发方法确保了手册的实用性，而混合方法设计则可以针对手册的可用性、可接受性和作为支持工具的可行性提供有针对性的输入。
