Palliative Care Provision by Rural General Practitioners in New Zealand

Smyth, Dot; Farnell, Alan; Dutu, Gaelle; Lillis, Steven; Lawrenson, Ross

doi:10.1089/jpm.2009.0097

Cited by 17 publications

(21 citation statements)

References 8 publications

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“…The rural and remote context provides many positive aspects for palliative care. There is consistent evidence that many people prefer to be cared for at home at the end of life, and that this is particularly important to those living in rural and remote areas who otherwise, would experience isolation and distress if they had to travel into urban areas for care [4,7,8]. Local health care practitioners bring the added benefits for patients of longstanding care relationships, higher levels of community accountability and an understanding of local issues [4,9,10].…”

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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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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“…, Smyth et al . ). What was evident in this study was though partnership working had been achieved, it requires constant attention and effort to be sustained.…”

Section: Discussionmentioning

confidence: 97%

“…However, New Zealand differs from the United Kingdom in that general practice visits are usually only part funded and so cost has also been identified as a barrier to general practice involvement in palliative care provision (McKinlay & McBain , Smyth et al . ).…”

Section: Introductionmentioning

confidence: 97%

General practice and specialist palliative care teams: an exploration of their working relationship from the perspective of clinical staff working in New Zealand

Keane

Bellamy

Gott

2015

Health Soc Care Community

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With the future focus on palliative and end-of-life care provision in the community, the role of the general practice team and their relationship with specialist palliative care providers is key to responding effectively to the projected increase in palliative care need. Studies have highlighted the potential to improve co-ordination and minimise fragmentation of care for people living with palliative care need through a partnership between generalist services and specialist palliative care. However, to date, the exact nature of this partnership approach has not been well defined and debate exists about how to make such partnerships work successfully. The aim of this study was to explore how general practice and specialist palliative care team (SPCT) members view their relationship in terms of partnership working. Five focus group discussions with general practices and SPCT members (n = 35) were conducted in 2012 in two different regions of New Zealand and analysed using a general inductive approach. The findings indicate that participants' understanding of partnership working was informed by their identity as a generalist or specialist, their existing rules of engagement and the approach they took towards sustaining the partnership. Considerable commitment to partnership working was shown by all participating teams. However, their working relationship was based primarily on trust and personal liaison, with limited formal systems in place to enable partnership working. Tensions between the cultures of 'generalism' and 'specialism' also provided challenges for those endeavouring to meet palliative care need collaboratively in the community. Further research is required to better understand the factors associated with successful partnership working between general practices and specialist palliative care in order to develop robust strategies to support a more sustainable model of community palliative care.

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“…This cannot be a fulltime job for anyone in a rural area, but must be incorporated into another job, e.g., family practice, hospitalist, etc. As Smyth et al 12 recently noted in New Zealand, palliative care for the average rural practitioner constituted just 7.3 patients in 12 months; specialist consultation was available and used by 77% of rural practitioner, but in the United States would only help sustain the program if compensated. The success of the program will depend on the drive of the practitioner, willingness for flexible work hours, ability to survive on what most doctors would find a paltry income, and the support of his or her family.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Financial Impact of a Palliative Care Program at a Small Rural Hospital

Cassel

Webb-Wright

Holmes

et al. 2010

Journal of Palliative Medicine

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Palliative Care Provision by Rural General Practitioners in New Zealand

Cited by 17 publications

References 8 publications

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

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

General practice and specialist palliative care teams: an exploration of their working relationship from the perspective of clinical staff working in New Zealand

Clinical and Financial Impact of a Palliative Care Program at a Small Rural Hospital

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