Mrs Claire Marshall1, Dr Claudia Virdun1,2,3, Professor Jane Phillips1,3
1University of Technology, Sydney, Sydney, Australia, 2Flinders University, Adelaide, Australia, 3Queensland University of Technology, Brisbane, Australia
Biography:
Claire is an experienced palliative care and cancer nurse who has worked across acute, community and rural settings, and has worked in academia since 2016. Claire lives in regional WA, which places her in a unique position to assist with health service development in regional, rural and remote areas, an issue which sits at the core of her PhD studies examining and developing optimal models of rural palliative care. Claire is supervised by Professor Jane Phillips and Dr Claudia Virdun.
Abstract:
Background: Despite 45% of the world’s population living in rural areas, there is little to guide the provision of optimal palliative care for these populations. Exploring rural consumers’ perspectives about their palliative care experiences assists in identifying the key aspects of care that enabled patients to remain in their communities.
Aim: To identify the key palliative care elements that rural patients with palliative care needs and their families perceive to be critical to receiving the care and support they need to live well.
Design and Data Sources: A systematic review and meta-synthesis registered with Prospero (CRD42020154273). Three databases were searched in July 2023. Raw qualitative data were extracted and analysed using Thomas and Harden's meta-synthesis approach, and findings reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results: Of 10288 identified papers, 11 met the inclusion criteria. The meta-synthesis of quotes (n=216) revealed three major themes: 1) the general practitioner (GP) is integral to good palliative care; 2) strategically timed access to specialist palliative care services, clinicians, and equipment is critical; and 3) patients and families express a need to feel safe, prepared and supported across their end-of-life trajectory.
Conclusion: Population-based models that include GPs strategically supported by specialist palliative care providers, optimises rural palliative care delivery. General practitioners are embedded in their communities; are the conduit to specialist palliative care services and referral processes; and contribute significantly to patient and carer feelings of safety and security. Ensuring these aspects of care quality are reflected in national and jurisdictional policy is a critical next step to enabling optimal palliative care in rural locations.
Prospero Registration ID: CRD42020154273 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=154273