Evaluating a model of delivering specialist palliative care services in rural New Zealand
Amanda Landers 1 , Danielle Dawson 2 , Fiona Doolan-Noble 31 Nurse Maude Hospice Palliative Care Service, Nurse Maude Association, Christchurch, New Zealand and Department of Medicine, University of Otago, New Zealand
2 West Coast Primary Health Organisation, Greymouth, New Zealand
3 Department of General Practice and Rural Health, University of Otago, New Zealand
Correspondence to: Amanda Landers, Department of Medicine, University of Otago, Christchurch 8140, New Zealand. Email: Amanda.Landers@nursemaude.org.nz
Journal of Primary Health Care 10(2) 125-131 https://doi.org/10.1071/HC18004
Published: 28 June 2018
Journal Compilation © Royal New Zealand College of General Practitioners 2018.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Various methods of delivering specialist palliative care to rural areas have been discussed in the literature, but published evaluations of these models are sparse. This study surveyed the stakeholders of a rural specialist palliative care service (SPCS) to help identify potential gaps and inform planning regarding the future vision.
METHODS: A survey was sent to all relevant stakeholders across the West Coast of New Zealand, including staff in primary care, aged residential care and the hospital. It focused on understanding the local model of palliative care, the quality of the current service and perceived gaps.
RESULTS: Thirty-three per cent of the surveys were returned, from a cross-section of health-care providers. The medical respondents rated the quality of the service higher than nursing and allied health participants. All of the groups reported feeling the specialist palliative care team (SPCT) was under-resourced. Additional educational opportunities were considered essential.
DISCUSSION: Stakeholders found the service easy to access, but improvements in communication, educational opportunities and forward planning were identified as being needed. This information helps the West Coast SPCT plan its future direction and develop a higher-quality service that meets the needs of all stakeholders.
KEYwords: Palliative care; service delivery; rural; evaluation
References
[1] World Health Organization. Definition of palliative care. 1998 [cited 2017 August]. Available from: www.who.int/cancer/palliative/definition.[2] Kelley ML. Developing rural communities’ capacity for palliative care: a conceptual model. J Palliat Care. 2007; 23 143
[3] Robinson CA, Pesut B, Bottorff JL, et al. Rural palliative care: a comprehensive review. J Palliat Med. 2009; 12 253–8.
| Rural palliative care: a comprehensive review.Crossref | GoogleScholarGoogle Scholar |
[4] Crawford GB. Palliative care on Kangaroo Island. Aust J Rural Health. 2000; 8 35–40.
| Palliative care on Kangaroo Island.Crossref | GoogleScholarGoogle Scholar |
[5] McGrath CL. Issues influencing the provision of palliative care services to remote Aboriginal communities in the Northern Territory. Aust J Rural Health. 2000; 8 47–51.
| Issues influencing the provision of palliative care services to remote Aboriginal communities in the Northern Territory.Crossref | GoogleScholarGoogle Scholar |
[6] Keim-Malpass J, Mitchell EM, Blackhall L, et al. Evaluating stakeholder-identified barriers in accessing palliative care at an NCI-designated cancer center with a rural catchment area. J Palliat Med. 2015; 18 634–7.
| Evaluating stakeholder-identified barriers in accessing palliative care at an NCI-designated cancer center with a rural catchment area.Crossref | GoogleScholarGoogle Scholar |
[7] Evans R, Stone D, Elwyn G. Organizing palliative care for rural populations: a systematic review of the evidence. Fam Pract. 2003; 20 304–10.
| Organizing palliative care for rural populations: a systematic review of the evidence.Crossref | GoogleScholarGoogle Scholar |
[8] Eriksson G, Bergstedt TW, Melin-Johansson C. The need for palliative care education, support, and reflection among rural nurses and other staff: a quantitative study. Palliat Support Care. 2015; 13 265–74.
| The need for palliative care education, support, and reflection among rural nurses and other staff: a quantitative study.Crossref | GoogleScholarGoogle Scholar |
[9] Masso M, Owen A. Linkage, coordination and integration: evidence from rural palliative care. Aust J Rural Health. 2009; 17 263–7.
| Linkage, coordination and integration: evidence from rural palliative care.Crossref | GoogleScholarGoogle Scholar |
[10] Bakitas MA, Elk R, Astin M, et al. Systematic review of palliative care in the rural setting. Cancer Control. 2015; 22 450–64.
| Systematic review of palliative care in the rural setting.Crossref | GoogleScholarGoogle Scholar |
[11] Sach J. Issues for palliative care in rural Australia. Collegian. 1997; 4 22–7.
| Issues for palliative care in rural Australia.Crossref | GoogleScholarGoogle Scholar |
[12] Ministry of Health. Measuring what matters. Wellington, New Zealand: Ministry of Health; 2012.
[13] Fink RM, Oman KS, Youngwerth J, et al. A palliative care needs assessment of rural hospitals. J Palliat Med. 2013; 16 638–44.
| A palliative care needs assessment of rural hospitals.Crossref | GoogleScholarGoogle Scholar |
[14] Crooks VA, Castleden H, Schuurman N, Hanlon N. Visioning for secondary palliative care service hubs in rural communities: a qualitative case study from British Columbia’s interior. BMC Palliat Care. 2009; 8 15
| Visioning for secondary palliative care service hubs in rural communities: a qualitative case study from British Columbia’s interior.Crossref | GoogleScholarGoogle Scholar |
[15] Phillips JL, Davidson PM, Jackson D, et al. Enhancing palliative care delivery in a regional community in Australia. Aust Health Rev. 2006; 30 370–9.
| Enhancing palliative care delivery in a regional community in Australia.Crossref | GoogleScholarGoogle Scholar |
[16] Hatton I, Mcdonald K, Nancarrow L, et al. The Griffith area palliative care service: a pilot project. Aust Health Rev. 2003; 26 11–8.
| The Griffith area palliative care service: a pilot project.Crossref | GoogleScholarGoogle Scholar |
[17] Spice R, Paul LR, Biondo PD. Development of a rural palliative care program in the Calgary Zone of Alberta Health Services. J Pain Symptom Manage. 2012; 43 911–24.
| Development of a rural palliative care program in the Calgary Zone of Alberta Health Services.Crossref | GoogleScholarGoogle Scholar |
[18] Pesut B, Bottorff JL, Robinson CA. Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care. BMC Med Ethics. 2011; 12 19
| Be known, be available, be mutual: a qualitative ethical analysis of social values in rural palliative care.Crossref | GoogleScholarGoogle Scholar |
