Abstract
Hospitals have played a leading role in providing palliative care in Taiwan as its care model has developed over the past few decades. However, earlier local studies in Taiwan showed that terminal patients prefer to die at home, highlighting the need to promote community-based palliative care instead of hospital-based care. Along with this shift, how community nurses provide palliative home care merits further exploration. This qualitative descriptive study aims to understand (1) how community nurses implement community-based palliative care, (2) what preparations are needed, and (3) what challenges they may face. Purposive sampling was used for recruiting nurses. We conducted one-on-one, in-depth, semi-structured interviews. Interview recordings were transcribed verbatim and analyzed using thematic analysis. Eight community nurses with a range of experience in palliative home care were interviewed. Four major themes emerged: (1) Opportunities, (2) Qualifications, (3) Support, and (4) Commitments. Psychological preparedness, well-developed professional capabilities, external assistance, and peer support motivate community nurses to offer community-based palliative care. As the requests for palliative home care services increase, community nurses play a critical role in palliative home care. Although the sample size is small and the findings retrieved from a small number of experiences might not be generalized to every region, the study results could inform future experience-sharing and workshop sessions to train more nurses for community-based care, expanding service coverage, and providing optimal palliative care.
Highlights
Introduction iationsThe demand for palliative home care is increasing globally, because of both cancer and non-cancer patients’ needs for a more approachable and continuous care system in order to get a rapid response [1,2]
Home care differs from hospital care due to the need to be prepared to receive calls from patients or family members, because when terminal patients are at home, the first line of assistance for patients and their families in case of emergencies is often the community nurses
Regarding the decision to commit to community-based palliative care, the results show that accumulating clinical experiences in the past strengthens their determination
Summary
We conducted a qualitative descriptive study using semi-structured in-depth interviews to examine the following issues: (1) the opportunities and preparations for providing community-based palliative care and (2) the challenges in offering the service. The reporting of this study complies with the consolidated criteria for reporting qualitative research (COREQ) recommendations [19]
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