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A reassuring presence: An evaluation of Bradford District Hospice at Home service

By Beverley J. Lucas, Neil A. Small, Peter Greasley and A. Daley

Abstract

Within the United Kingdom, a developing role for primary care services in cancer and palliative care has resulted in an increase in palliative home care teams. The provision of professional care in the home setting seeks to provide necessary services and enhanced choice for patients whose preference is to die at home.\ud A mismatch between patient preference for home death and the actual number of people who died at home was identified within Bradford, the locality of this study. In response to this mismatch, and reflecting the policy environment of wishing to enhance community service provision, the four Primary Care Trusts (PCTs) in the city sought to offer support to patients who wished to remain in their own homes through the final stages of a terminal illness. To offer this support they set up a dedicated hospice at home team. This would provide services and support for patients in achieving a dignified, symptom free and peaceful death, allowing families to maximise time spent together. The aim of the study was to evaluate the Bradford hospice at home service from the perspective of carers, nurses and General Practitioners.\ud Postal questionnaires were sent to carers (n = 289), district nurses (n = 508) and GP's (n = 444) using Bradford's hospice at home service. Resulting quantitative data was analysed using the Statical Package for Social Sciences (SPSS) and qualitative data was analysed using grounded theory techniques.\ud The data from carers, district nurses and GPs provide general support for the Bradford hospice at home service. Carers valued highly the opportunity to 'fulfil a promise' to the individual who wished to be cared for at home. District nurses and GPs cited the positive impact of access to specialist expertise. This was a 'reassuring presence' for primary healthcare teams and offered 'relief of carer anxiety' by providing prompt, accessible and sensitive care.\ud Carers and health professionals welcomed the increased possibility of patients being cared for at home. The study identified the need to focus on improving skill levels of staff and on ensuring continuity of care

Topics: Bradford Disctrict Hospice, ; Home service, ; Evaluation
Year: 2008
OAI identifier: oai:bradscholars.brad.ac.uk:10454/589
Provided by: Bradford Scholars

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Citations

  1. (1999). A: Patient and carer preference for, and satisfaction with, specialist models of palliative care: a systematic literature review. Palliative Medicine doi
  2. (1967). AL: The discovery of grounded theory
  3. (2003). An out-of-hours protocol for community palliative care: practitioners' perspectives. doi
  4. (1991). Balance of care for the dying between hospitals and the community: perceptions of general practitioners, hospital consultants, community nurses and relatives.
  5. (1998). Basics of qualitative research; techniques and procedures for developing grounded theory London: Sage; doi
  6. (2005). Bereaved carers' views of a hospice at home service. doi
  7. (2000). Bruera E: Predictors of home death in palliative care cancer patients. Journal of Palliative care
  8. (1994). Can home care maintain an acceptable quality of life for patients with terminal cancer and their relatives? Palliative Medicine doi
  9. (2000). Casuccio : The impact of home palliative care on symptoms in advanced cancer patients. Supportive Care in Cancer doi
  10. (1998). CJ: Place of death and access to home care services: are certain patient groups at a disadvantage? Soc Sci Med doi
  11. (2004). CJ: Valued aspects of primary palliative care: content analysis of bereaved carers' descriptions.
  12. (2003). Coyte P: Recruitment issues in healthcare research: the situation in home care. Health and Social Care in the Community doi
  13. (2006). DM: Factors predicative of preferred place of death in the general population of South Australia. Palliative Medicine doi
  14. (1999). Does Hospital at home for palliative care facilitate death at home? Randomised controlled trial. doi
  15. (2000). Dying at home: evaluation of a hospice rapid-response service. doi
  16. (1998). Evaluating health interventions Buckingham: doi
  17. (2004). Evaluation and social research Hampshire: Palgrave Macmillan;
  18. (2005). Exploring district nurses' experience of a hospice at home service. doi
  19. (2004). for Clinical Excellence: Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer
  20. (2003). Gold standard palliative care in the community. Primary Health Care doi
  21. (2006). Health: Our health, our care, our say: a new direction for community services doi
  22. Higginson IJ: Factors influencing death at home in terminally ill patients with cancer: systematic review. doi
  23. (1994). Hospice care in the United Kingdom. Ann Acad Med Singapore
  24. (2003). I: Respite in palliative care: a review and discussion of the literature. Palliative Medicine doi
  25. (2000). Macmillan Carers Schemes in England: results of a multicentre evaluation. Palliative Medicine doi
  26. (2001). McIllmurray MB: Place of death in Morecambe Bay; patterns and preferences for place of final care and death among terminally ill cancer patients and their carers.
  27. National Clinical Director: Cancer Reform Strategy [http:// www.dh.gov.uk]. accessed
  28. (2004). National Forum for Hospice at Home: Submission to Health Select Committee
  29. (1989). Preferred versus actual place of death: a hospital palliative care support team experience. Palliative Medicine doi
  30. (2007). Radbruch L: Criteria for successful multiprofessional cooperation in palliative care teams. Palliative Medicine doi
  31. (2002). Real world research: a resource for social scientists and practitioner-researchers 2nd edition. doi
  32. (2006). Recording and auditing preferred place of death. Palliative Medicine doi
  33. (1998). Satisfaction with palliative care: what should we be aware of? doi
  34. (1990). Terminal cancer care and patients' preference for place of death: a prospective study. BMJ doi
  35. (2000). The level of need for palliative care: a systematic review of the literature. Palliative Medicine doi
  36. (2007). The patient experience of community hospital – the process of care as a determinate of satisfaction. doi
  37. (1978). Theoretical sensitivity California:
  38. (2003). Travers E: Hospice at home 2: evaluating a crisis intervention service. doi

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