Valued aspects of primary palliative care: content analysis of bereaved carers' descriptions.
BACKGROUND
Informal carers provide the bulk of palliative home care. They largely rely on general practitioners (GPs) and district nurses to support them in this role, yet little is known about what carers themselves consider important in this support.


OBJECTIVE
To identify what informal carers valued in the palliative support provided by GPs and district nurses by using carers' own descriptions of such support.


METHODS
Retrospective interviews.


METHODS
Primary care in Cambridgeshire.


METHODS
Semi-structured interviews with bereaved carers of 48 patients with cancer and 12 patients with non-cancer diagnoses. Content analysis of carers' evaluative descriptions of GP and district nurse support.


RESULTS
The accessibility of the GP and district nurse emerged as the most important aspect of support. Enlistment of help from other agencies was also extensively mentioned, together with provision of equipment. Attitude or approach during interactions, and relationship with the professional were important, particularly regarding GP support, whereas support for the carer, information, and symptom control were mentioned less often. Data suggested that support was not as good for older patients (> or =75 years), but this finding requires further investigation.


CONCLUSIONS
Results largely confirmed findings of previous, quantitative research and the importance of a patient-centred approach. What emerged most strongly, however, was the central importance of accessibility of support services for lay carers responsible for end-of-life home care. This mainly concerned GP and district nurse support, but accessibility of additional care and equipment were also important. In short, carers' main focus was the basic support that enabled them to sustain care in the home.
School of Nursing, Midwifery and Health, University of Manchester, Manchester, UK. Gunn.Grande@man.ac.uk
Gunn E
GE
Grande
Morag C
MC
Farquhar
Stephen Ig
SI
Barclay
Chris J
CJ
Todd
D000368:Aged; D001291:Attitude of Health Personnel; D001601:Bereavement; D017028:Caregivers / Q000523:psychology*; D003625:Data Collection; D005194:Family Practice / Q000592:standards; D005260:Female; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing*; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010817:Physician-Patient Relations; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods* / Q000523:psychology