The bittersweet experiences of providers of Home-Based Palliative Care (HBPalC): a qualitative study on the provider perspectives of HBPalC in Kerala, India.

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Resmi Madhavanpillai Indirabhai, Chithralekha Leela, Arya Rahul, Thekkumkara Surendran Anish
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引用次数: 0

Abstract

Background: Home-based care is a fundamental component of the Kerala model of palliative care, which has received global recognition. The study explores the experiences of palliative care providers caring for a vulnerable community of patients. Findings may assist in identifying gaps and replicating Kerala's palliative care model in other settings.

Methods: This descriptive qualitative study was conducted among palliative care providers (PCPs) and other stakeholders working with the Pain and Palliative Care Project of the National Health Mission (NHM), Thiruvananthapuram District, Kerala. Three Focus Group Discussions and 21 In-Depth Interviews were conducted among a purposively sampled group of participants including palliative care providers and patients. The validity of the data was ensured by data triangulation and member checks using standard methodologies. All interviews were audio recorded and thematic analysis was done using the Braun & Clarke method.

Results: PCPs experienced a multitude of positive and negative experiences and challenges. They found contentment in establishing an intimate relationship with patients and their families, getting the opportunity to deliver need-based quality care, crossing the hurdles of social acceptance and creating opportunities from challenges; giving them a feeling of satisfaction and self-worth. Challenges faced by caregivers included a lack of acceptance from patients/families, stress, burnout, and helplessness. Additionally, although the program was running efficiently in the community, palliative care providers faced administrative, organizational, and personal barriers that they felt impeded their contributions.

Conclusions: The study gives an in-depth illustration of the challenges and ambivalent experiences of palliative care providers working under Kerala's home-based palliative care programme, providing care to a vulnerable section of society. The caregivers themselves represent an underprivileged community of nurses who struggle to provide the highest possible care despite the challenges and difficulties.

背景介绍居家姑息关怀是喀拉拉姑息关怀模式的基本组成部分,该模式已获得全球认可。本研究探讨了姑息关怀服务提供者为弱势病人群体提供关怀的经验。研究结果可能有助于找出差距,并在其他环境中推广喀拉拉邦的姑息关怀模式:这项描述性定性研究的对象是姑息关怀医疗服务提供者(PCPs)和喀拉拉邦 Thiruvananthapuram 区国家卫生使命(NHM)疼痛与姑息关怀项目的其他利益相关者。对包括姑息关怀服务提供者和患者在内的参与者进行了三次焦点小组讨论和 21 次深入访谈。采用标准方法对数据进行三角测量和成员检查,确保数据的有效性。所有访谈都进行了录音,并使用布劳恩和克拉克方法进行了主题分析:初级保健医生经历了许多积极和消极的经历和挑战。他们在与患者及其家属建立亲密关系、有机会提供以需求为基础的优质护理、跨越社会接受的障碍以及从挑战中创造机遇等方面感到满足;这给他们带来了满足感和自我价值感。护理人员面临的挑战包括缺乏患者/家属的认可、压力、职业倦怠和无助感。此外,尽管该项目在社区中有效运行,但姑息关怀服务提供者面临着行政、组织和个人方面的障碍,他们认为这些障碍阻碍了他们的贡献:本研究深入阐述了在喀拉拉邦居家姑息关怀项目下工作的姑息关怀服务提供者所面临的挑战和矛盾的经历,他们为社会中的弱势群体提供关怀。护理人员本身就代表着一个弱势群体,尽管面临挑战和困难,他们仍努力提供尽可能最好的护理服务。
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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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