The role of general practitioners in continuity of care at the end of life: a qualitative study of terminally ill patients and their next of kin
The role of general practitioners in continuity of care at the end of life: a qualitative study of terminally ill patients and their next of kin
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DOI：
10.1177/0269216307078503
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发表时间：
2007-01-01
影响因子：
4.4
通讯作者：
Deliens, Luc
中科院分区：
文献类型：
--
作者：
Michiels, Eva;Deschepper, Reginald;Deliens, Luc
目的：探讨临终病人对全科医生在提供持续的临终关怀中的作用的看法，并确定障碍。设计：对患者进行定性访谈研究（两次连续访谈）。地点：比利时。参与者：17名晚期癌症患者，了解诊断和预后。结果：临终病人属性的关键作用，以全球定位系统在不同方面的两种类型的连续性。关系的连续性：与同一个家庭医生保持持续的关系，其中重要的方面是，例如，在转诊后保持联系，并对患者负责。信息连续性：利用过去事件和个人情况的信息提供个性化护理，其中重要的方面是全科医生、专家和护理机构之间的信息交流。患者还发现了连续性的障碍，例如，缺乏时间和全科医生的主动性。结论：在生命的尽头，当医生不再依赖诊断-治疗-治愈的生物医学模型时，患者的观点至关重要。这项定性研究使人们有可能获得洞察终端病人的看法，连续初级临终关怀。它澄清了这一概念，并确定了这一概念的障碍。
Objectives: Exploring terminal patients' perceptions of GPs' role in delivering continuous end-of-life care and identifying barriers to this. Design: Qualitative interview study with patients (two consecutive interviews). Setting: Primary care Belgium. Participants: Seventeen terminally ill cancer patients, informed about diagnosis and prognosis. Results: Terminal patients attribute a pivotal role to GPs in different aspects of two types of continuity. Relational continuity: having an ongoing relationship with the same GP, of which important aspects are eg, keeping in touch after referral and feeling responsible for the patient. Informational continuity: use of information on past events and personal circumstances to provide individualised care, of which important aspects are eg, exchange of information between GPs, specialists and care facilities. Patients also identify barriers to continuity eg, lack of time and of GPs' initiative. Conclusions: At the end of life when physicians can no longer rely on biomedical models of diagnosis-therapy-cure, patients' perspectives are of utmost importance. This qualitative study made it possible to gain insights into terminal patients' perceptions of continuous primary end-of-life care. It clarifies the concept and identifies barriers to it.