Access and referral to palliative care for patients with chronic heart failure: A qualitative study of healthcare professionals.

Singh, GK; Ramjan, L; Ferguson, C; Davidson, PM; Newton, PJ

Access and referral to palliative care for patients with chronic heart failure: A qualitative study of healthcare professionals.

Singh, GK Ramjan, L Ferguson, C

Davidson, PM Newton, PJ

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Publisher:: WILEY
Publication Type:: Journal Article
Citation:: Journal of clinical nursing, 2020, 29, (9-10), pp. 1576-1589
Issue Date:: 2020-05

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Field	Value	Language
dc.contributor.author	Singh, GK
dc.contributor.author	Ramjan, L
dc.contributor.author	Ferguson, C https://orcid.org/0000-0002-2417-2216
dc.contributor.author	Davidson, PM
dc.contributor.author	Newton, PJ
dc.date.accessioned	2020-07-28T05:57:16Z
dc.date.available	2020-02-05
dc.date.available	2020-07-28T05:57:16Z
dc.date.issued	2020-05
dc.identifier.citation	Journal of clinical nursing, 2020, 29, (9-10), pp. 1576-1589
dc.identifier.issn	0962-1067
dc.identifier.issn	1365-2702
dc.identifier.uri	http://hdl.handle.net/10453/141895
dc.description.abstract	BACKGROUND:Palliative care for individuals with chronic heart failure is recommended for improving patients' symptoms, function and overall quality of life. Despite this mandate, there is limited access and referral to specialist palliative care for individuals with chronic heart failure. OBJECTIVES:To explore healthcare professionals' perspectives on access to palliative care for patients with chronic heart failure, focussing on patient, provider and system factors. METHODS:Cardiologists, palliative care specialists, heart failure nurses and palliative care nurses in acute and community care settings were interviewed using semi-structured interviews. Purposive and snowball sampling methods were used for recruitment. Interview data were analysed using thematic analysis. The COREQ checklist guided data collection and reporting. RESULTS:There were 15 participants in the study, and the majority were female. Participants included palliative medicine physicians, a palliative care nurse consultant, cardiologists, a general practitioner and advanced heart failure nurses. The themes derived from the thematic analysis centred on patient, provider and system factors impacting access and referral to palliative care in the context of chronic heart failure. The patient themes were (a) patient and family preconception of palliative care and (b) patient's clinical profile influences referral. The provider themes were (a) conflict, (b) making decisions and (c) education needs, and the system themes were (a) accessing services and resources and (b) improving the model of care. CONCLUSIONS:The patient's clinical profile, education needs of healthcare professionals and improving access to services and resources need to be considered to enhance palliative care access and referral as well as the interacting and influencing elements of the patient, provider and system.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	WILEY
dc.relation.ispartof	Journal of clinical nursing
dc.relation.isbasedon	10.1111/jocn.15222
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing, 1117 Public Health and Health Services, 1701 Psychology
dc.subject.classification	Nursing
dc.title	Access and referral to palliative care for patients with chronic heart failure: A qualitative study of healthcare professionals.
dc.type	Journal Article
utslib.citation.volume	29
utslib.location.activity	England
utslib.for	1110 Nursing
utslib.for	1117 Public Health and Health Services
utslib.for	1701 Psychology
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-07-28T05:57:09Z
pubs.issue	9-10
pubs.publication-status	Published
pubs.volume	29
utslib.citation.issue	9-10

Abstract:

BACKGROUND:Palliative care for individuals with chronic heart failure is recommended for improving patients' symptoms, function and overall quality of life. Despite this mandate, there is limited access and referral to specialist palliative care for individuals with chronic heart failure. OBJECTIVES:To explore healthcare professionals' perspectives on access to palliative care for patients with chronic heart failure, focussing on patient, provider and system factors. METHODS:Cardiologists, palliative care specialists, heart failure nurses and palliative care nurses in acute and community care settings were interviewed using semi-structured interviews. Purposive and snowball sampling methods were used for recruitment. Interview data were analysed using thematic analysis. The COREQ checklist guided data collection and reporting. RESULTS:There were 15 participants in the study, and the majority were female. Participants included palliative medicine physicians, a palliative care nurse consultant, cardiologists, a general practitioner and advanced heart failure nurses. The themes derived from the thematic analysis centred on patient, provider and system factors impacting access and referral to palliative care in the context of chronic heart failure. The patient themes were (a) patient and family preconception of palliative care and (b) patient's clinical profile influences referral. The provider themes were (a) conflict, (b) making decisions and (c) education needs, and the system themes were (a) accessing services and resources and (b) improving the model of care. CONCLUSIONS:The patient's clinical profile, education needs of healthcare professionals and improving access to services and resources need to be considered to enhance palliative care access and referral as well as the interacting and influencing elements of the patient, provider and system.

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http://hdl.handle.net/10453/141895