The role of general practitioners in continuity of care at the end of life: a qualitative study of terminally ill patients and their next of kin.
OBJECTIVE
Exploring terminal patients' perceptions of GPs' role in delivering continuous end-of-life care and identifying barriers to this.


METHODS
Qualitative interview study with patients (two consecutive interviews).


METHODS
Primary care Belgium.


METHODS
Seventeen terminally ill cancer patients, informed about diagnosis and prognosis.


RESULTS
Terminal patients attribute a pivotal role to GPs in different aspects of two types of continuity. Relational continuity: having an ongoing relationship with the same GP, of which important aspects are eg, keeping in touch after referral and feeling responsible for the patient. Informational continuity: use of information on past events and personal circumstances to provide individualised care, of which important aspects are eg, exchange of information between GPs, specialists and care facilities. Patients also identify barriers to continuity eg, lack of time and of GPs' initiative.


CONCLUSIONS
At the end of life when physicians can no longer rely on biomedical models of diagnosis-therapy-cure, patients' perspectives are of utmost importance. This qualitative study made it possible to gain insights into terminal patients' perceptions of continuous primary end-of-life care. It clarifies the concept and identifies barriers to it.
Michiels
Eva
E
Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
Deschepper
Reginald
R
Van Der Kelen
Greta
G
Bernheim
Jan L
JL
Mortier
Freddy
F
Vander Stichele
Robert
R
Deliens
Luc
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001530:Belgium; D003266:Continuity of Patient Care / Q000592:standards*; D005192:Family Health; D005194:Family Practice / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010819:Physician's Role / Q000523:psychology; D010817:Physician-Patient Relations; D036301:Qualitative Research; D019984:Quality Indicators, Health Care / Q000592:standards*; D013727:Terminal Care / Q000523:psychology / Q000592:standards*; D019452:Terminally Ill