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Barriers to the provision of high-quality palliative care for people with dementia in England: a qualitative study of professionals' experiences.

Davies, N; Maio, L; Vedavanam, K; Manthorpe, J; Vernooij-Dassen, M; Iliffe, S; (2014) Barriers to the provision of high-quality palliative care for people with dementia in England: a qualitative study of professionals' experiences. Health Soc Care Community , 22 (4) pp. 386-394. 10.1111/hsc.12094. Green open access

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Abstract

Approaches to palliative care that were originally developed for people with cancer are now being adopted for people with dementia, as a response to many reports of poor-quality care for people with dementia at the end of life. This study explored perceived barriers to the delivery of high-quality palliative care for people with dementia using semi-structured interviews. Recordings were transcribed verbatim and analysed using thematic analysis with an inductive approach and a coding strategy. To improve the trustworthiness of the analysis, independent reading and coding of the transcripts were undertaken, followed by discussions among the four researchers to reach agreement and consensus of the themes. Two group interviews (n = 7 and n = 6), 16 individual interviews and five interviews of pairs of professionals were conducted in 2011/2012 with participants from backgrounds in palliative care, dementia services, palliative care research and policy making. Four themes were identified as barriers to providing high-quality palliative care for people with dementia: (i) ambivalence towards the systematisation of palliative care; (ii) disconnection between services; (iii) different assumptions about training needs; and (iv) negotiation of risk. Understanding these barriers to providing high-quality palliative care for people with dementia could help in the development of a dementia-specific palliative care pathway.

Type: Article
Title: Barriers to the provision of high-quality palliative care for people with dementia in England: a qualitative study of professionals' experiences.
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/hsc.12094
Publisher version: http://dx.doi.org/10.1111/hsc.12094
Additional information: © 2013 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: dementia, palliative care, qualitative research, quality of healthcare, terminal care
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1434073
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