Building Capacity to Provide Palliative Care in Rural and Remote Communities Does Education Make a Difference?

Kelley, Mary Lou; Habjan, Sonja; Aegard, Joanna

doi:10.1177/082585970402000407

Cited by 27 publications

(22 citation statements)

References 26 publications

(30 reference statements)

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“…For face-to-face interventions, where the programme was delivered, for example in a local or regional centre [44,50,54,57,65], was also important, relating to successful outcomes such as capacity to attend the programme.…”

Section: Resultsmentioning

confidence: 99%

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

et al. 2014

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ObjectiveTo identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts.DesignThis is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts.ResultsThis review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme.ConclusionThrough a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

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Section: Resultsmentioning

confidence: 99%

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

et al. 2014

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“…In this way, connections were made with the context in which the care was being delivered, while drawing on a range of professional opinion and expertise. Discussion that ensued between rural and remote practitioners and the multidisciplinary panel situated in the tertiary centre facilitated the development of professional networks, which could lead to more effective care [15]. However, while a multidisciplinary approach was adopted for many sessions, the content value by profession was variable.…”

Section: Discussionmentioning

confidence: 99%

“…Studies suggest that providing continuing education to local staff can improve rural palliative care [15,16] and reduce attrition rates in the rural workforce [17]. More importantly, rural practitioners value access to education and support as a means of enhancing the delivery of care in their communities [18].…”

Section: Introductionmentioning

confidence: 99%

Palliative care professional education via video conference builds confidence to deliver palliative care in rural and remote locations

Ray

Fried

Lindsay

2014

BMC Health Serv Res

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BackgroundPeople living in rural and remote locations are disadvantaged in accessing palliative care. This can be attributed to several factors including the role diversity and the low numbers of patients with specific conditions, as well as the difficulties rural health practitioners have in accessing opportunities for professional education. A program of multidisciplinary palliative care video conferences was presented to health practitioners across part of northern Australia in an effort to address this problem.MethodThe educational content of the video conferences was developed from participant responses to an educational needs assessment. Following cycles of four consecutive video conferences, 101 participants completed evaluative on-line surveys. The quantitative data were analysed using frequencies and analysis of variance tests with post-hoc analyses where appropriate, and an accessibility and remoteness index was used to classify their practice location.ResultsAll participants found the content useful regardless of their remoteness from the tertiary centre, their years of experience caring for palliative care patients or the number of patients cared for each year. However, change in confidence to provide palliative care as a result of attending the video conferences was significant across all disciplines, regardless of location. Doctors, medical students and allied health professionals indicated the greatest change in confidence.ConclusionsThe provision of professional education about palliative care issues via multidisciplinary video conferencing increased confidence among rural health practitioners, by meeting their identified need for topic and context specific education. This technology also enhanced the networking opportunities between practitioners, providing an avenue of ongoing professional support necessary for maintaining the health workforce in rural and remote areas. However, more attention should be directed to the diverse educational needs of allied health professionals.

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“…The empowerment of primary carers by consultation and education by paediatric palliative care specialists is crucial in order to establish local networks, especially when taking into account the heterogeneous range of diseases requiring paediatric palliative care. For example, Kelley et al have developed a customised education programme for the expansion of palliative care delivery in rural areas in Ontario (Canada) with the aim of empowering those carers who do not have specialist palliative care training [26]. Education in the field of paediatric palliative care deserves careful consideration regarding the appropriate form, extent, and specificity of the programme.…”

Section: Discussionmentioning

confidence: 99%

Paediatric palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives

et al. 2010

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BackgroundNon-specialist palliative care, as it is delivered by general practitioners, is a basic component of a comprehensive palliative care infrastructure for adult patients with progressive and far advanced disease. Currently palliative care for children and adolescents is recognized as a distinct entity of care, requiring networks of service providers across different settings, including paediatricians working in general practice. In Germany, the medical home care for children and adolescents is to a large extent delivered by general paediatricians working in their own practice. However, these are rarely confronted with children suffering from life-limiting diseases. The aim of this study was therefore to examine potential barriers, incentives, and the professional self-image of general paediatricians with regard to paediatric palliative care.MethodsBased on qualitative expert interviews, a questionnaire was designed and a survey among general paediatricians in their own practice (n = 293) was undertaken. The survey has been developed and performed in close cooperation with the regional professional association of paediatricians.ResultsThe results showed a high disposition on part of the paediatricians to engage in palliative care, and the majority of respondents regarded palliative care as part of their profile. Main barriers for the implementation were time restrictions (40.7%) and financial burden (31.6%), sole responsibility without team support (31.1%), as well as formal requirements such as forms and prescriptions (26.6%). Major facilitations were support by local specialist services such as home care nursing service (83.0%), access to a specialist paediatric palliative care consultation team (82.4%), as well as an option of exchange with colleagues (60.1%).ConclusionsAltogether, the high commitment to this survey reflects the relevance of the issue for paediatricians working in general practice. Education in basic palliative care competence and communication skills was seen as an important prerequisite for the engagement in paediatric palliative home care. A local network of specialist support on site and a 24/7 on-call service are necessary in order to facilitate the implementation of basic palliative care by paediatricians in their own practice.

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Building Capacity to Provide Palliative Care in Rural and Remote Communities Does Education Make a Difference?

Cited by 27 publications

References 26 publications

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes

Palliative care professional education via video conference builds confidence to deliver palliative care in rural and remote locations

Paediatric palliative home care by general paediatricians: a multimethod study on perceived barriers and incentives

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