title: Palliative care by family physicians in the 1990s. Resilience amid reform.
abstract: OBJECTIVE
  To explore issues family physicians face in providing community-based palliative care to their patients in the context of a changing health care system.
  
  
  METHODS
  Focus groups.
  
  
  METHODS
  Small (< 10,000 population), medium-sized (10,000 to 50,000), and large (> 50,000) communities in Nova Scotia.
  
  
  METHODS
  Twenty-five men and women physicians with varying years of practice experience in both solo and group practices.
  
  
  METHODS
  A semistructured approach was used, asking physicians to reflect on recent palliative care experiences in order to explore issues of care.
  
  
  RESULTS
  Five themes emerged from the discussions: resources needed, availability of family support, time and money supporting physicians' activities, symptom control for patients, and physicians' emotional reactions to caring for dying patients.
  
  
  CONCLUSIONS
  With downsizing of hospitals and greater emphasis on community-based care, the issues identified in this study will need attention, particularly in designing an integrated service delivery model for palliative care.
authors.affiliation: Dalhousie University, Department of Family Medicine, Abbie J. Lane Building, 8th Floor, 5909 Veterans Memorial Lane, Halifax, NS B3H 2E2.
authors.forename: F
authors.initials: F
authors.lastname: Burge
authors.forename: P
authors.initials: P
authors.lastname: McIntyre
authors.forename: P
authors.initials: P
authors.lastname: Twohig
authors.forename: I
authors.initials: I
authors.lastname: Cummings
authors.forename: D
authors.initials: D
authors.lastname: Kaufman
authors.forename: G
authors.initials: G
authors.lastname: Frager
authors.forename: A
authors.initials: A
authors.lastname: Pollett
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D005190:Family / Q000523:psychology; D005194:Family Practice; D005260:Female; D017144:Focus Groups; D006285:Health Planning; D006295:Health Resources; D006801:Humans; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D010146:Pain / Q000517:prevention & control; D010166:Palliative Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D012944:Social Support; D013727:Terminal Care / Q000458:organization & administration* / Q000523:psychology