Evaluating palliative care: facilitating reflexive dialogues about an ambiguous concept.
Palliation is a relatively new concept that is used in connection with the integral care provided to those who are unable to recover from their illness. The specific meaning of the concept has not been clearly defined. This article explores the possibilities offered by a responsive approach to evaluation that can facilitate a reflexive dialogue on this ambiguous concept. In doing so it draws on a case study of a palliative care project in a Dutch health care authority. The article begins with an overview of the characteristics of a responsive approach to evaluation and addresses interpretative, representational and practical dilemmas. It goes on to present a series of dialogues between health professionals, informal caregivers, patients and evaluators. These dialogues take the form of juxtaposed stories, transcribed conversations and interpretations. Finally, the learning experiences are summarised and the appropriateness of the responsive approach to evaluate palliative care is discussed.
Abma
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Institute for Health Care Policy and Management, Erasmus University, PO Box 1738, 3000 DR Rotterdam, The Netherlands. abma@bmg.eur.nl
D004989:Ethics; D006801:Humans; D007398:Interpersonal Relations; D007400:Interprofessional Relations; D033262:Narration; D009723:Nurse-Patient Relations; D010166:Palliative Care; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011368:Professional-Family Relations; D015397:Program Evaluation; D009626:Terminology as Topic