IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), University of Technology Sydney, Sydney, NSW, Australia.
Flinders Research Centre for Palliative Care, Death, and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.
Palliat Med. 2024 Oct;38(9):935-950. doi: 10.1177/02692163241269796. Epub 2024 Sep 10.
Almost half the world's population lives in rural areas. How best to provide palliative care to rural populations is unclear. Privileging rural patient and family voices about their experiences of receiving care delivered via rural palliative care models is necessary.
To identify the key palliative care elements that rural patients with palliative care needs and their families perceive to be critical to receiving the care and support they need to live well.
A systematic review and meta-synthesis registered with Prospero (CRD42020154273). Three databases were searched in June 2024. Raw qualitative data were extracted and analysed using Thomas and Harden's three-stage thematic synthesis methodology. Findings reported according to the PRISMA statement.
Of the 10,834 identified papers, 11 met the inclusion criteria. Meta-synthesis of extracted, raw quotes (n = 209) revealed three major themes: (1) Honouring the patient's existing relationship with their General Practitioner (GP); (2) strategically timed access to specialist services, clinicians and equipment is critical; and (3) a need to feel safe, prepared and supported.
The strategic inclusion of specialists alongside primary care providers is integral to optimising rural palliative care models. General Practioners are central to these models, through being embedded in their communities and as the conduit to specialist palliative care services. Rural palliative care patients and families value responsive care, trajectory signposting, effective communication, 24/7 support and recognise the value of virtual health. Globally, positive public policy and funding is critical to ensuring access to GP-led, specialist-supported, rural palliative care models.
全球近一半的人口居住在农村地区。如何为农村人口提供最佳的姑息治疗尚不清楚。优先考虑农村患者和家属对通过农村姑息治疗模式接受护理的体验的声音是必要的。
确定农村有姑息治疗需求的患者及其家属认为对接受他们需要的护理和支持以生活得更好至关重要的姑息治疗要素。
系统评价和荟萃综合，在 Prospéro（CRD42020154273）中注册。2024 年 6 月搜索了三个数据库。提取原始定性数据，并使用 Thomas 和 Harden 的三阶段主题综合方法进行分析。根据 PRISMA 声明报告结果。
在确定的 10834 篇论文中，有 11 篇符合纳入标准。对提取的原始引语（n=209）进行荟萃综合揭示了三个主要主题：（1）尊重患者与他们的全科医生（GP）现有的关系；（2）及时获得专科服务、临床医生和设备至关重要；（3）需要感到安全、有准备和得到支持。
在优化农村姑息治疗模式时，战略上纳入初级保健提供者和专科医生是必不可少的。全科医生通过嵌入他们的社区并作为专科姑息治疗服务的渠道，是这些模式的核心。农村姑息治疗患者和家属重视响应式护理、轨迹指示、有效沟通、24/7 支持，并认识到虚拟健康的价值。在全球范围内，积极的公共政策和资金对于确保获得由全科医生主导、专科医生支持的农村姑息治疗模式至关重要。
