Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues 英文参考文献.docVIP

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Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues 英文参考文献.doc

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Out-of-hours GPs and palliative care-a qualitative study exploring information exchange and communication issues 英文参考文献

TaubertandNelsonBMCPalliativeCare2010,9:18 /1472-684X/9/18 RESEARCH ARTICLE OpenAccess Out-of-hoursGPsandpalliativecare-aqualitative studyexploringinformationexchangeand communicationissues MarkTaubert1*,AnnmarieNelson2 Abstract Background:Out-of-hoursgeneralpractitioners(GPs)coverthecommunityoverasignificantproportionofa givenweek,andpalliativecarepatientsareseenasapriority.LittleisknownabouthowwelltheseGPsfeel supportedintheirlineofworkandwhethercommunicationexchangesworkwellfortheproportionoftheir patientswhohavepalliativecareneeds.Forthisstudy,GPswhoprovideout-of-hourscarewereinterviewedin ordertoexplorefactorsthattheyidentifiedasdetrimentalorbeneficialforgoodcommunicationbetween themselves,patients,relativesandotherprofessionals,specificallytopalliativecareencounters. Methods:NineGPswereinterviewedusingface-to-facesemi-structuredinterviews.AllnineGPsworkedregular out-of-hourssessions.DatafromtranscriptswasanalysedusingInterpretativePhenomenologicalAnalysis. Results:ApredominantthemeexpressedbyGPsrelatedtoconstraintswithinthesystemprovidedbythelocal privatecompanyownedout-of-hoursprovider.Astrongfeelingof‘beingaloneoutthere’emerged,withsome GPsmorewillingtocallforhelpthanothers,andothersexpressingtheirconcernataccesstopharmaciesand medicationbeingveryinconsistent. Out-of-hoursGPsfeltleftaloneonoccasion,unabletoaccessdaytimeservicesandnotknowingwhotocallfor advice.Informationhand-oversystemsfromin-hourstoout-of-hourswithregardtopalliativecarewerefelttobe inadequate.Out-of-hoursdoctorsinterviewedfeltleftoutofthecareloop;handoversheetsfromspecialistpallia- tivecareproviderswereararity. Conclusions:Out-of-hoursservicesneedtobemindfuloftheneedsoftheGPstheyemploy,inparticularrelating tothepalliativecaretheyprovideinthissetting.Otherhealthcareprofessionalsshouldaimtokeeptheirlocalout- of-hoursserviceinformedaboutpalliativecarepatientstheymaybecalledtosee. Background conduct of general practitioners, with admission, sus- Out-of-hours service provision in the United K