What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program

Ankuda, Claire K.; Kersting, Kaileen; Guetterman, Timothy C.; Haefner, Jessica; Fonger, Evan; Paletta, Michael; Hopp, Faith

doi:10.1177/1049909117691929

Cited by 10 publications

(10 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PCPs are already performing elements of palliative care, such as advance care planning, 23 yet several key attributes of care for patients with serious illness are hard for PCPs to provide, such as emotional support, spiritual support, practical assistance, and social services. 6,24 Considering that other specialists believe referrals to palliative care should come from PCPs, 8 PCPs need better support in caring for their patients with serious illness, including identifying when specialized care is needed. HBPC can likely fill that role, if PCPs are willing to try and programs are willing to adapt.…”

mentioning

confidence: 99%

Engaging Primary Care Physicians to Refer Patients to Home-Based Palliative Is Challenging and Complicated

Kogan

Sadamitsu

Gaddini³

et al. 2020

Palliative Medicine Reports

View full text Add to dashboard Cite

Background: Before the Affordable Care Act (ACA), the financing landscape for fee-for-service health care lacked broad structure and incentives to provide palliative care outside hospitals. Since the ACA, several payers have taken the opportunity to offer home-based palliative care (HBPC) to their members. Objective: To evaluate the impact of outreach efforts by a physician champion among a cohort of primary care physicians (PCPs) to introduce a new HBPC program and benefit, obtain buy-in, and motivate referrals for Blue Shield patients. Design: Secondary qualitative analysis of detailed field notes from a HBPC physician champion from in-person meetings with a cohort of PCPs and their office staff. Subjects: PCPs were from a physicians group in northern California that met with the physician champion during a 12-month study period. Results: During the 12-month study period, the physician champion met with clinicians at 27 distinct primary care offices. Qualitative analyses revealed three independent themes relating to receptivity and perception of the new HBPC program: (1) physician-level factors (overburdened, lack of palliative care knowledge, misconceptions around palliative care, and patient control), (2) practice-level factors (practice structure and role/integration of advance practice providers), and (3) first impression of the HBPC program (receptivity, ''dirty data,'' and communication). Conclusion: Results hold important implications for practice and new approaches to engaging PCPs in HBPC, obtaining buy-in, and generating patient referrals. PCPs need better support in caring for patients with serious illness and HBPC can likely fill that role if PCPs are willing to refer and HBPC programs adapt.

show abstract

mentioning

confidence: 99%

Engaging Primary Care Physicians to Refer Patients to Home-Based Palliative Is Challenging and Complicated

Kogan

Sadamitsu

Gaddini³

et al. 2020

Palliative Medicine Reports

View full text Add to dashboard Cite

show abstract

“…Nearly half of the articles (43.4%) evaluated an intervention, program, or service, such as a mindfulness-based stress reduction training program for lung cancer patients and their partners [16], a conversation game to engage individuals in end-of-life discussions [17], and a home-based palliative care service [18]. Other study purposes included investigating a research topic in palliative care and end-of-life research (32.1%), developing a tool (11.9%), a quantitative instrument (6.3%) or an intervention (3.8%), and assessing palliative care needs (2.5%) (see the specific focus of each article in Supplementary Materials S3).…”

Section: Characteristics Of Articles Reporting Mixed Methods Studiesmentioning

confidence: 99%

A Methodological Review of Mixed Methods Research in Palliative and End-of-Life Care (2014–2019)

Fàbregues

Hong

Escalante-Barrios

et al. 2020

IJERPH

Self Cite

View full text Add to dashboard Cite

Mixed methods research has been increasingly recognized as a useful approach for describing and explaining complex issues in palliative care and end-of-life research. However, little is known about the use of this methodology in the field and the ways in which mixed methods studies have been reported. The purpose of this methodological review was to examine the characteristics, methodological features and reporting quality of mixed methods articles published in palliative care research. The authors screened all articles published in eight journals specialized in palliative care between January 2014 and April 2019. Those that reported a mixed methods study (n = 159) were included. The Good Reporting of a Mixed Methods Study (GRAMMS) criteria were used to assess reporting quality. Findings showed that 57.9% of the identified studies used a convergent design and 82.4% mentioned complementarity as their main purpose for using a mixed methods approach. The reporting quality of the articles generally showed a need for improvement as authors usually did not describe the type of mixed methods design used and provided little detail on the integration of quantitative and qualitative methods. Based on the findings, recommendations are made to improve the quality of reporting of mixed methods articles in palliative care.

show abstract

“…Overcoming language barriers is crucial in regard to patients' rights and when achieving informed consent is needed. Systematic review of 30 articles pointed out three main themes: "palliative care practice within the family, trust as a precondition of palliative care, and the importance of knowledge and cultural competency" (44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56).…”

Section: Palliative Care For Migrants In General Practicementioning

confidence: 99%

Narrative review of home care for palliative patients in general practice

Despotova-Toleva

Toleva-Nowak

2021

Ann Palliat Med

View full text Add to dashboard Cite

The need of palliative care is constantly growing worldwide and the spectrum of patients and diseases, leading to the need of palliative care is very broad (1). According to recently published data in the "Letter for National Palliative Care Advocates to send to government lead on Universal Health coverage, and UN negotiations" (2) by 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious health-related suffering, and 83% of these deaths will occur in low-income and middleincome countries.Due to the phenomenon of the so-called "silver tsunami" (the increasing number of elderly, and those of them with severe, incurable, life-limiting and life-threatening diseases) the problem escalates dramatically. Thus, significant and urgent changes should be made in some basic documents, including "Suggested language changes to zero draft 'Political Declaration of the High-level Meeting on

show abstract

What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program

Abstract: This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.

Cited by 10 publications

References 23 publications

Engaging Primary Care Physicians to Refer Patients to Home-Based Palliative Is Challenging and Complicated

Engaging Primary Care Physicians to Refer Patients to Home-Based Palliative Is Challenging and Complicated

A Methodological Review of Mixed Methods Research in Palliative and End-of-Life Care (2014–2019)

Narrative review of home care for palliative patients in general practice

Contact Info

Product

Resources

About