Process Evaluation of a Mixed Methods Feasibility Study to Identify Hospital Patients with Palliative Care Needs in Portugal.
Pereira Rodrigues, Pedro
Higginson, Irene J
Lopes Ferreira, Pedro
Acta medica portuguesa
Centro Editor Livreiro da Ordem dos Médicos, Sociedade Unipessoal
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Antunes, B., Pereira Rodrigues, P., Higginson, I. J., & Lopes Ferreira, P. (2021). Process Evaluation of a Mixed Methods Feasibility Study to Identify Hospital Patients with Palliative Care Needs in Portugal.. Acta medica portuguesa https://doi.org/10.20344/amp.15294
Background: Evidence shows most patients are not recognised by their attending healthcare professionals as having palliative needs. This feasibility study aimed to aid healthcare professionals identify hospital patients with palliative needs. Methods: Mixed-methods, cross-sectional, observational study. Patient inclusion criteria: ≥18 years, mentally capable to give consent judged by participating healthcare professionals, if unable, have a legal substitute to consent, diagnosed with an incurable, potentially life-threatening illness. Field notes were taken for reflexive purposes. Measures: Integrated Palliative care Outcome Scale, surprise question, phase of illness, referral request status, The Eastern Cooperative Oncology Group Performance Status and social needs assessment. A mid data collection period meeting assessed implementation outcomes in each context. A web-based survey was sent to all participating healthcare professionals at the end of data collection period to explore overall experiences of participation and implementation outcomes. Results: Forty-two services in 4 hospitals were contacted. The study was presented in 9 services. Field notes were vital to understand recruitment process and difficulties experienced: time constraints, fear of added work, service dynamics and organisation, relationships between services and need of training in palliative care and research. One service agreed to participate. There were 6 participating healthcare professionals and only 45 patients included. Three participating healthcare professionals responded to the web-based survey. Discussion: Participation rate was very low. Based in our results, legislating palliative care is not enough, an integrated palliative care plan needs to be implemented at country and institution. Conclusion: There is an urgent need to provide generalist palliative care training to clinicians.
Bárbara Antunes was funded by Foundation for Science and Technology (FCT) - Grant number PD/BD/113664/2015, Faculty of Medicine, University of Porto. The Doctoral Program Clinical and Health Services Research was funded by FCT - Grant number PD/0003/2013. Currently Bárbara Antunes is funded by the National Institute for Health Research (NIHR) Applied Research Collaboration East of England (ARC EoE) programme. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. The funding organizations had no role in the design of the study, collection, analysis, interpretation of the data, or writing of the manuscript.
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External DOI: https://doi.org/10.20344/amp.15294
This record's URL: https://www.repository.cam.ac.uk/handle/1810/318863
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