[Quality of care in specialized palliative homecare from the provider perspective: A qualitative study].
Versorgungsqualität in der spezialisierten ambulanten Palliativversorgung aus Sicht der Leistungserbringer: eine qualitative Studie.
Culture of care
Homecare
Palliative care
Palliativversorgung
Qualitative Studien
Qualitative studies
Quality of care
SAPV
Versorgungskultur
Versorgungsqualität
Journal
Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen
ISSN: 2212-0289
Titre abrégé: Z Evid Fortbild Qual Gesundhwes
Pays: Netherlands
ID NLM: 101477604
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
09
11
2020
revised:
20
01
2021
accepted:
06
02
2021
pubmed:
7
4
2021
medline:
18
5
2021
entrez:
6
4
2021
Statut:
ppublish
Résumé
Since its introduction in 2007, the quality of care in specialized palliative home care (SAPV) is being measured using the patients' perspective. The perception of beneficial or inhibiting factors on the quality of care from the perspective of care providers received only little attention. To investigate the factors that promote or impede the quality of care in SAPV from the care providers' perspective. Within the framework of a transregional qualitative study, 113 problem-centered interviews were conducted on-site at 10 SAPV providers with their staff as well as their network partners. Grounded theory methodology was used for data curation and analysis. The factors that are perceived as either enhancing or inhibiting the quality of care largely depends on the culture of care of the individual SAPV provider. For participating doctors, nurses and psychosocial professionals, successful performance is associated with good symptom control, participation of relatives and the achievement of certainty of action and of interpretation by means of 'good' decision-making procedures. Problematic performances are linked to a lack of time resulting in restlessness and especially in disagreement between the parties involved in the provision of care as well as to the denial of death. The results of the study show that the perceived strategies, interpretations and evaluation categories, which are associated with good quality of care, are very heterogenous. On the basis of qualitative data, they do, however, follow three typical patterns in terms of cultures of care: proceduralism, holism and dualism.
Sections du résumé
BACKGROUND
BACKGROUND
Since its introduction in 2007, the quality of care in specialized palliative home care (SAPV) is being measured using the patients' perspective. The perception of beneficial or inhibiting factors on the quality of care from the perspective of care providers received only little attention.
OBJECTIVE
OBJECTIVE
To investigate the factors that promote or impede the quality of care in SAPV from the care providers' perspective.
METHODS
METHODS
Within the framework of a transregional qualitative study, 113 problem-centered interviews were conducted on-site at 10 SAPV providers with their staff as well as their network partners. Grounded theory methodology was used for data curation and analysis.
RESULTS
RESULTS
The factors that are perceived as either enhancing or inhibiting the quality of care largely depends on the culture of care of the individual SAPV provider. For participating doctors, nurses and psychosocial professionals, successful performance is associated with good symptom control, participation of relatives and the achievement of certainty of action and of interpretation by means of 'good' decision-making procedures. Problematic performances are linked to a lack of time resulting in restlessness and especially in disagreement between the parties involved in the provision of care as well as to the denial of death.
CONCLUSIONS
CONCLUSIONS
The results of the study show that the perceived strategies, interpretations and evaluation categories, which are associated with good quality of care, are very heterogenous. On the basis of qualitative data, they do, however, follow three typical patterns in terms of cultures of care: proceduralism, holism and dualism.
Identifiants
pubmed: 33820720
pii: S1865-9217(21)00033-7
doi: 10.1016/j.zefq.2021.02.005
pii:
doi:
Types de publication
Journal Article
Langues
ger
Sous-ensembles de citation
IM
Pagination
1-9Informations de copyright
Copyright © 2021. Published by Elsevier GmbH.