Abstract
Background: Early access to rehabilitation can improve quality of life for those with life-limiting illnesses and is highlighted as a core component of the Adult Palliative Care Services Model of Care for Ireland. Despite this, palliative rehabilitation remains under-utilised and under-developed. In 2020, the Sláintecare Integration Fund provided opportunity to pilot a novel rehabilitative palliative care service, "Palliat Rehab". This protocol proposes a case study, which aims to advance understanding of the form, content, and delivery of the pilot service. Methods: A prospective, longitudinal, mixed-methods, case study design will be used to describe the service and to explore the experiences of patients, informal carers and clinicians. Additionally, data collection instruments will be tested and the utility of outcome measures will be examined. Data will be collected from documentary, survey, and interview sources. Quantitative data will be analysed using descriptive statistics, including chi-square tests for categorical variables, Mann-Whitney U tests for ordinal data, and t-tests/ ANOVA for continuous data. Qualitative data will be analysed using thematic analysis. Conclusions: New pathways are required to advance service provision to ensure that patients receive the 'right care, in the right place, at the right time'. The development of ''Palliat Rehab'' offers opportunity to study an innovative service and consider its potential contribution to the achievement of Sláintecare goals. Investigating the service within its environmental context will lead to a better understanding of 'how' and 'why' things happen. Findings will be of value in assessing whether there is evidence that supports the service, and will be used to inform efforts to further develop and tailor the intervention.
Highlights
The number of older people living with a palliative care need in Ireland is projected to increase by 89% between 2016 to 20461
In 2016, the authors of a narrative synthesis concluded that there remained a lack of consensus on when and how rehabilitative palliative care should be offered and recommended that further research was required with regards to methods, activities, frameworks, and practice guidelines for service provision[5]
Guided by an exploratory case study framework[16], and adopting a post-positivist approach[17], this case study will examine the novel service as delivered by one hospital organisation and one community-based organisation for an 18-month period of service provision and will provide insight into the delivery of palliative care rehabilitation
Summary
The number of older people living with a palliative care need in Ireland is projected to increase by 89% between 2016 to 20461. The population will account disproportionately for disability burden, pain prevalence and health care use, leading to increased population health burdens and health care utilisation. It is estimated, for example, that there will be a 106% increase in requirement for the hours of healthcare delivered at home[1]. In 2020, the Sláintecare Integration Fund provided opportunity to pilot a novel rehabilitative palliative care service, “Palliat Rehab”. This protocol proposes a case study, which aims to advance understanding of the form, content, and delivery of the pilot service. Findings will be of value in assessing whether there is evidence that supports the service, and will be used to inform efforts to further develop and tailor the intervention
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