Skomakerstuen Ødbehr Liv, Hov Reidun, Sanaker Harald, Sandsdalen Tuva
Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, University of Inland Norway, Elverum, Norway.
Centre for Development of Institutional and Home Care Services Inland (Hedmark) Norway, Hamar Municipality, Norway.
J Multidiscip Healthc. 2025 Jan 25;18:395-406. doi: 10.2147/JMDH.S487153. eCollection 2025.
The palliative phase of a patient's life is often characterized by disease complexity, increasing the need for holistic care, support for the patient's relatives, and the up-to-date knowledge of a multidisciplinary healthcare team. Physicians in nursing homes have the main responsibility for providing palliative care to vulnerable and fragile patients. There is limited research uncovering physicians' experience and perceptions of what is important in this phase of patients' lives. The aim of the study was thus to investigate physicians' perceptions of factors that influence the quality of palliative care in Norwegian nursing homes and their descriptions of the importance of the team's collaboration.
The study has a qualitative research design based on interviews with twelve nursing home physicians in Eastern Norway. Interviews were conducted between February 2023 to May 2023, analyzed using qualitative content analysis.
Three themes describe the content of the findings: i) Comprehensive care plans enhance the quality of palliative care, ii) A collaborative team provides higher-quality care than the sum of its parts, iii) Systemic and environmental factors affect the ability to ensure continuity of care.
The physicians in this study expressed that the quality of palliative care in nursing homes depended on comprehensive care plans, including up-to-date knowledge of medical treatment options, partnership with the patient and relatives, and a consistent holistic approach to the patient. The quality also depended on the interdisciplinary team's collaboration in assessing the patient, observing symptoms, and planning further care and treatment in accordance with patients' and their relatives' preferences and wishes. Finally, systemic and environmental factors affected the ability to ensure continuity of care. Further work is needed to ensure that systemic factors enable physicians to deliver high-quality palliative care and that a comfortable physical environment is created in nursing homes.
患者生命的姑息治疗阶段通常以疾病复杂性为特征，这增加了对整体护理、患者亲属支持以及多学科医疗团队最新知识的需求。养老院的医生主要负责为脆弱的患者提供姑息治疗。关于医生在患者生命这一阶段对重要事项的经验和看法的研究有限。因此，本研究的目的是调查医生对影响挪威养老院姑息治疗质量的因素的看法，以及他们对团队协作重要性的描述。
本研究采用定性研究设计，基于对挪威东部12名养老院医生的访谈。访谈于2023年2月至2023年5月进行，采用定性内容分析法进行分析。
三个主题描述了研究结果的内容：i）全面的护理计划提高了姑息治疗的质量，ii）协作团队提供的护理质量高于其各部分之和，iii）系统和环境因素影响确保护理连续性的能力。
本研究中的医生表示，养老院姑息治疗的质量取决于全面的护理计划，包括对医疗治疗选择的最新知识、与患者及其亲属的合作，以及对患者始终如一的整体方法。质量还取决于跨学科团队在评估患者、观察症状以及根据患者及其亲属的偏好和意愿规划进一步护理和治疗方面的协作。最后，系统和环境因素影响确保护理连续性的能力。需要进一步努力确保系统因素使医生能够提供高质量的姑息治疗，并在养老院营造舒适的物理环境。
