Abstract
ObjectiveThe aims of the study were to examine a) patients’ knowledge of palliative care, b) patients’ expectations and needs when being admitted to a palliative care unit, and c) patient’s concept of a good palliative care physician.MethodsThe study was based on a qualitative methodology, comprising 32 semistructured interviews with advanced cancer patients admitted to the palliative care unit of the Medical University of Vienna. Interviews were conducted with 20 patients during the first three days after admission to the unit and after one week, recorded digitally, and transcribed verbatim. Data were analyzed using NVivo 10 software, based on thematic analysis enhanced with grounded theory techniques.ResultsThe results revealed four themes: (1) information about palliative care, (2) supportive care needs, (3) being treated in a palliative care unit, and (4) qualities required of palliative care physicians. The data showed that patients lack information about palliative care, that help in social concerns plays a central role in palliative care, and attentiveness as well as symptom management are important to patients. Patients desire a personal patient-physician relationship. The qualities of a good palliative care physician were honesty, the ability to listen, taking time, being experienced in their field, speaking the patient’s language, being human, and being gentle. Patients experienced relief when being treated in a palliative care unit, perceived their care as an interdisciplinary activity, and felt that their burdensome symptoms were being attended to with emotional care. Negative perceptions included the overtly intense treatment.ConclusionsThe results of the present study offer an insight into what patients expect from palliative care teams. Being aware of patient’s needs will enable medical teams to improve professional and individualized care.
Highlights
Palliative care involves a multidisciplinary and individual approach, consisting of professional care in the form of optimum symptom control, psychosocial and spiritual care and support in the organization of everyday life
The results revealed four themes: (1) information about palliative care, (2) supportive care needs, (3) being treated in a palliative care unit, and (4) qualities required of palliative care physicians
The data showed that patients lack information about palliative care, that help in social concerns plays a central role in palliative care, and attentiveness as well as symptom management are important to patients
Summary
Palliative care involves a multidisciplinary and individual approach, consisting of professional care in the form of optimum symptom control, psychosocial and spiritual care and support in the organization of everyday life. Administrative, and economic reasons, there are several other factors contributing to the underrepresentation of palliative care in health politics These include both patients and physicians‘ uncertainties about its exact purpose, physician‘s uncertainty concerning the prognosis of the patients and emotional barriers of some physicians to initiate end-of-life-conversations due to the fear of undermining the patient's hopes of recovery [7]. A distinct feature of hospices —unlike palliative care units—in Austria is that they are not regularly funded by the state. Their purpose is to accompany the patients in the final phase of life until their death. The data were analyzed and the results discussed with a view to preparing patients as well as caregivers prior to admission to a palliative care unit
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