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Stakeholders' views on identifying patients in primary care at risk of dying: a qualitative descriptive study using focus groups and interviews.
Urquhart, Robin; Kotecha, Jyoti; Kendell, Cynthia; Martin, Mary; Han, Han; Lawson, Beverley; Tschupruk, Cheryl; Marshall, Emily Gard; Bennett, Carol; Burge, Fred.
Afiliação
  • Urquhart R; Department of Surgery, Dalhousie University; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
  • Kotecha J; Research and Business Development, Beaty Water Research Centre.
  • Kendell C; Department of Surgery.
  • Martin M; Centre for Studies in Primary Care (CSPC), Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
  • Han H; Centre for Studies in Primary Care (CSPC), Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
  • Lawson B; Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Tschupruk C; Palliative Care Integration, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
  • Marshall EG; Nova Scotia Health Authority; Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
  • Bennett C; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  • Burge F; Nova Scotia Health Authority; Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Br J Gen Pract ; 68(674): e612-e620, 2018 Sep.
Article em En | MEDLINE | ID: mdl-30104331
ABSTRACT

BACKGROUND:

Strategies have been developed for use in primary care to identify patients at risk of declining health and dying, yet little is known about the perceptions of doing so or the broader implications and impacts.

AIM:

To explore the acceptability and implications of using a primary care-based electronic medical record algorithm to help providers identify patients in their practice at risk of declining health and dying. DESIGN AND

SETTING:

Qualitative descriptive study in Ontario and Nova Scotia, Canada.

METHOD:

Six focus groups were conducted, supplemented by one-on-one interviews, with 29 healthcare providers, managers, and policymakers in primary care, palliative care, and geriatric care. Participants were purposively sampled to achieve maximal variation. Data were analysed using a constant comparative approach.

RESULTS:

Six themes were prevalent across the dataset early identification is aligned with the values, aims, and positioning of primary care; providers have concerns about what to do after identification; how we communicate about the end of life requires change; early identification and subsequent conversations require an integrated team approach; for patients, early identification will have implications beyond medical care; and a public health approach is needed to optimise early identification and its impact.

CONCLUSION:

Stakeholders were much more concerned with how primary care providers would navigate the post-identification period than with early identification itself. Implications of early identification include the need for a team-based approach to identification and to engage broader communities to ensure people live and die well post-identification.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Paliativos / Atenção Primária à Saúde / Doença Crônica / Fragilidade Tipo de estudo: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Br J Gen Pract Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Cuidados Paliativos / Atenção Primária à Saúde / Doença Crônica / Fragilidade Tipo de estudo: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Aspecto: Patient_preference Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Revista: Br J Gen Pract Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá