P-131 Healthcare professionals’ views of rehabilitative palliative care

Abstract

Background As people in the UK are living longer with incurable diseases, it has been acknowledged that hospices need to review their provision of care (Calanzani, Higginson & Gomes, 2013). The adoption of a rehabilitative palliative care approach is recommended, which aims to optimise people’s function, wellbeing and independence within the limitations of an advancing illness (Tiberini & Richardson, 2015). There is limited research examining the perspective of healthcare professionals (HCPs) working in hospices regarding rehabilitative palliative care (Wosahlo & Maddocks, 2015). Aims To explore the views and experiences of HCPs working in hospice in-patient settings of rehabilitative palliative care to inform practice in hospice in-patient units. Methods Jan-March 2017: Literature review and ethics application. April-June 2017: recruitment from two hospices. Qualitative approach: semi-structured interviews with HCPs working in hospice in-patient settings. Topic guide and field notes used. June-Sept 2017: interview audio-recordings transcribed verbatim, systematically analysed using Iterative Categorization (Neale, 2016) and themes developed from the data. Results 18 interviews conducted: nine nurses, three healthcare assistants, two doctors, two physiotherapists and two occupational therapists. Themes identified included a shared common understanding of rehabilitative palliative care and highlighted that aspects of this approach were practised within hospices. Barriers and enablers to rehabilitative palliative care were identified, including multidisciplinary team work and communication, the concept of ‘tucking up’ patients, the patient and family, and external perceptions of hospices. Healthcare assistants’ understanding of other HCPs’ roles highlighted the need for further education in this area. Conclusions Whilst rehabilitation is not new to palliative care, the findings suggest this approach is going through a developmental and formalisation process. Increased interdisciplinary team working and further training in rehabilitative palliative care for hospice staff would be beneficial to embedding this approach in hospices. The findings show that healthcare assistants, who provide a large proportion of patient ‘hands on care’, would particularly benefit from additional training to incorporate rehabilitative palliative care into their practice.