Family physicians’ role in palliative care throughout the care continuum: stakeholder perspectives

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Abstract

Background.

While palliative care is still often viewed as care for the final stage of life provided usually by specialist health care professionals, ideally, a palliative care approach would start at an earlier stage, with an important role being assigned to the family physician (FP). However, the description of what the FP’s tasks would be in the integration of a palliative care approach into the care continuum remains vague.

Objective.

To explore the views of FPs, nurses and patients about the tasks of the FP in palliative care for people with a life-limiting illness from diagnosis onwards.

Methods.

We performed 18 interviews with people with cancer, organ failure or dementia and 6 focus groups, 4 with FPs and 2 with community nurses. Analysis was guided by a thematic content analysis procedure to categorize perceived tasks into overarching themes.

Results.

The tasks attributed to the FP could be categorized into four roles: FP as (i) available medical expert, (ii) communicator, (iii) collaborator and (iv) life-long learner committed to improving their palliative care competencies by training. Some perceived tasks varied depending on the different phases of illness (such as around diagnosis), while others were applicable throughout the whole illness course. Participants mostly had the same perception of the FPs’ tasks, but there was disagreement on, for example, the timing of care planning.

Conclusion.

Our results help to elucidate the tasks and roles required of FPs to make integration of a palliative care approach into the care continuum possible.

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