Joshi Melanie, Dillen Kim, Krumm Norbert, Hesse Michaela, Brunsch Holger, Strupp Julia, Radbruch Lukas, Rolke Roman, Voltz Raymond
Faculty of Medicine and University Hospital, Department of Palliative Medicine, University of Cologne, Cologne, Germany.
Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.
BMC Health Serv Res. 2025 Feb 13;25(1):245. doi: 10.1186/s12913-025-12258-y.
An increasing number of patients in the palliative phase of their disease are cared for at home by palliative home care services. A sense of security, normality of everyday life and symptom control are found to be active factors of quality of care in Specialized Palliative Home Care. Whether this also applies to General Palliative Home Care has not yet been systematically investigated. The aim of this study was to identify distinctions between General and Specialized Palliative Home Care from a healthcare professional's perspective concerning those factors.
With a qualitative approach, we conducted 11 semi-structured interviews with healthcare professionals from different professional backgrounds in General and/or Specialized Palliative Home Care.
In both General and Specialized Palliative Home Care, healthcare-professionals (HCP) found a sense of security (through availability) to be most relevant for the patients. The majority saw aspects of normality of everyday life as a key component for high-quality palliative home care, especially having time for the patient and the family caregiver(s). However, statements about symptom control are mainly related to Specialized Palliative Home Care. The subcodes availability, having time and competence, symptom burden and financial resources were the main distinguishing factors between General and Specialized Palliative Home Care in sense of security, normality of everyday life and symptom control, respectively.
Our results provide the basis for a clearer definition of GPHC and SPHC and contribute to identifying factors for a transferal between the two services to provide best care for the patient. Distinguishing (sub)factors revealed challenges and short-term solutions. Providing (financial) incentives to guarantee time and availability in General Palliative Home Care would lead to more effective care.
越来越多处于疾病姑息治疗阶段的患者由姑息家庭护理服务机构在家中接受护理。安全感、日常生活的正常状态和症状控制被认为是专业姑息家庭护理中护理质量的积极因素。这是否也适用于一般姑息家庭护理尚未得到系统研究。本研究的目的是从医疗保健专业人员的角度确定一般姑息家庭护理和专业姑息家庭护理在这些因素方面的区别。
我们采用定性方法,对来自一般和/或专业姑息家庭护理不同专业背景的医疗保健专业人员进行了11次半结构化访谈。
在一般姑息家庭护理和专业姑息家庭护理中,医疗保健专业人员(HCP)都发现(通过可获得性)安全感对患者最为重要。大多数人认为日常生活的正常状态方面是高质量姑息家庭护理的关键组成部分,特别是有时间陪伴患者和家庭照顾者。然而,关于症状控制的表述主要与专业姑息家庭护理相关。子代码可获得性、有时间和能力、症状负担和财务资源分别是一般姑息家庭护理和专业姑息家庭护理在安全感、日常生活正常状态和症状控制方面的主要区别因素。
我们的结果为更清晰地定义一般姑息家庭护理(GPHC)和专业姑息家庭护理(SPHC)提供了基础,并有助于确定两种服务之间转移的因素,以便为患者提供最佳护理。区分(子)因素揭示了挑战和短期解决方案。在一般姑息家庭护理中提供(财务)激励以保证时间和可获得性将导致更有效的护理。