This website is intended for healthcare professionals

Abstract

This study addressed the question ‘What are the needs of community nurses in delivering palliative care to people with long-term conditions?’ A qualitative exploratory descriptive design was employed. Ten community nurses (Band 5-7) were recruited from a purposive sample following a process of randomised stratified sampling, according to geographical area and Band for matched numbers. Semi-structured interviews were undertaken and audio recorded with written informed consent. The interviews were transcribed verbatim and analysed using an adapted Burnard's framework. The study found that establishing therapeutic relationships, having access to resources, co-ordination and provision of clinical care and collaborative working were all highlighted by the community nurses as needs in delivering palliative care. If these four needs were met, the community nurses believed they could deliver palliative care to their patients. Issues around a lack of resources, community nurses' educational needs and the late referral of patients with non-malignant long-term conditions to community nursing were also identified.

References

  • Boyd KJ, Worth A, Kendall M et al. (2009) Making sure services deliver for people with advanced heart failure: a longitudinal qualitative study of patients, family carers and health professionals. Palliat Med 23(8): 767–76 Crossref, MedlineGoogle Scholar
  • Burnard P (1991) A method of analysing interview transcripts in qualitative research. Nurse Educ Today 11: 461–66 Crossref, MedlineGoogle Scholar
  • Department of Health (2001) The Expert Patient: A New Approach to Chronic Disease Management for the 21st Century. DH, London Google Scholar
  • Department of Health (2005) The National Service Framework for Long-term Conditions. DH, London Google Scholar
  • Dunne K, Sullivan K, Kernohan G (2005) Palliative care for patients with cancer: district nurses' experiences. J Adv Nurs 50(4): 372–80 Crossref, MedlineGoogle Scholar
  • Exley C, Field D, Jones L, Stokes T (2005) Palliative care in the community for cancer and end-stage cardiorespiratory disease: the views of patients, lay-carers and health care professionals. Palliat Med 19: 76–83 Crossref, MedlineGoogle Scholar
  • Griffiths J, Ewing G, Rogers M et al. (2007) Supporting Cancer patients with palliative care needs: district nurses' role perceptions. Cancer Nursing 30(2): 156–62 Crossref, MedlineGoogle Scholar
  • Griggs C (2010) Community nurses' perceptions of a good death: a qualitative exploratory study. Int J Palliat Nurs 16(3): 139–48 LinkGoogle Scholar
  • Kendrick S (2004) Drivers for Change. Scottish Executive, Edinburgh Google Scholar
  • Kennedy C (2005) District nursing support for patients with cancer requiring palliative care. Br J Community Nurs 10(12): 566–74 LinkGoogle Scholar
  • Kennedy C, Elliott L, Rush R et al. (2009) Review of community nursing: Baseline Study Social Research: Health and Community Care. Scottish Government, Edinburgh Google Scholar
  • Luker KA, Austin L, Caress A, Hallett CE (2000) The importance of ‘knowing the patient’: community nurses’ construction of quality in providing palliative care. J Adv Nurs 31(4): 775–82 Crossref, MedlineGoogle Scholar
  • Murray SA, Boyd K, Sheikh A (2005) Palliative care in chronic illness. BMJ 330: 611–12 Crossref, MedlineGoogle Scholar
  • McKenzie H, Boughton M, Hayes L et al. (2007) A sense of security for cancer patients at home: the role of the community nurses. Health Soc Care Community 15(4): 352–9 Crossref, MedlineGoogle Scholar
  • McIlfatrick S (2007) Assessing palliative care needs: views of patients, informal carers and healthcare professionals. J Adv Nurs 57(1): 77–86 Crossref, MedlineGoogle Scholar
  • O'Brien M, Jack B (2010) Barriers to dying at home: the impact of poor coordination of community service provision for patients with cancer. Health Soc Care Community 18(4): 337–45 MedlineGoogle Scholar
  • Partnerships for Solutions (2001) The problem: chronic conditions. http://tiny.cc/n1rmu (accessed 25 May 2011) Google Scholar
  • Pellett C (2009) Provision of end of life care in the community. Nurs Stand 24(12): 35–40 Crossref, MedlineGoogle Scholar
  • Pratt LR (2006) Long-term conditions 5: meeting the needs of highly complex patients. Br J Community Nurs 11(6): 234–40 LinkGoogle Scholar
  • Scottish Executive (2005) Delivering for Health. Scottish Executive, Edinburgh Google Scholar
  • Scottish Government (2008) Living and Dying Well: a national action plan for palliative and end of life care in Scotland. Scottish Government, Edinburgh Google Scholar
  • Scottish Government (2009) Long Term Conditions Collaborative: Improving Complex Care. Scottish Government, Edinburgh Google Scholar
  • Shaw KL, Clifford C, Thomas K, Meehan H (2010) Improving end-of-life care: a critical review of the Gold Standards Framework in primary care. Palliat Med 24(3): 317–29 Crossref, MedlineGoogle Scholar
  • Spence A, Hasson F, Waldron M et al. (2009) Professionals delivering palliative care to people with COPD: qualitative study. Palliat Med 23: 126–31 Crossref, MedlineGoogle Scholar
  • Tullett M, Neno R (2008) Approaches to long-term conditions management and care for older people: similarities or differences? J Nurs Manag 16: 167–72 Crossref, MedlineGoogle Scholar
  • Wilkes L, Cioffi J, Warne B, Harrison K, Vonuboriceanu O (2008) Clients with chronic and complex conditions: their experiences of community nursing services. J Nurs Healthcare Chronic Illness 17(7b): 160–8 Google Scholar

This website is intended for healthcare professionals