General practitioners (GPs) and palliative care: perceived tasks and barriers in daily practice.
BACKGROUND
General practitioners (GPs) play a crucial part in palliative care. The quality of care can be improved by investigating and addressing barriers perceived by GPs in daily practice. The aim of this study was to investigate GPs' task perception and barriers involved in palliative care.


METHODS
Qualitative focus group study. We gathered together a group of GPs representing a broad range of experience in palliative care. Content analysis was performed to derive a comprehensive view of tasks and barriers in daily palliative care.


RESULTS
GPs described their palliative care tasks as satisfactory and varied, but burdensome. Palliative care tasks included somatic and psychosocial care. Opinions differed with respect to whether the coordination of care belonged to the primary GP tasks. Barriers were classified according to three levels: (1) personal: barriers related to knowledge, skills, emotions; (2) relational: barriers concerning communication and collaboration; (3) organizational: barriers related to the organization of care and compartmentalization in healthcare.


CONCLUSIONS
This study revealed a complex web of tasks and barriers. It may be possible to trace back a problem (lack of knowledge, for example) on the personal level to an isolated knowledge gap, but the problem may well have originated from communication or compartmentalization problems. To maintain GPs' feeling of being at ease with palliative care requires helping them acquire the appropriate balance between technical and organizational interventions and a compassionate orientation to their terminally ill patients.
Groot
Marieke M
MM
Centre for Quality of Care Research (229), University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands. c.groot@wok.umcn.nl
Vernooij-Dassen
Myrra J F J
MJ
Crul
Ben J P
BJ
Grol
Richard P T M
RP
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D005194:Family Practice / Q000458:organization & administration / Q000592:standards*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010166:Palliative Care / Q000458:organization & administration / Q000592:standards*; D010819:Physician's Role; D036301:Qualitative Research; D011787:Quality of Health Care; D013727:Terminal Care / Q000458:organization & administration / Q000592:standards