Using a quality framework to assess rural palliative care.
BACKGROUND
High-quality palliative care may remain out of reach for rural people who are dying. The purpose of this study was to explore the opportunities and issues affecting the provision of high-quality palliative care from the perspective of nurses employed in two rural health regions.


METHODS
Using an interpretive descriptive design, focus groups and in-depth individual interviews of 44 nurses were conducted.


RESULTS
Descriptions of challenges and opportunities fell into three themes: effectiveness and safety, patient-centredness, and efficiency and timeliness. Patient-centredness was seen as a major strength of rural palliative care. Major challenges included provision of adequate symptom management and support of home deaths. The scarcity of health human resources and the negative impact these shortages had on all dimensions of palliative care quality consistently underpinned the discussions.


CONCLUSIONS
Implementing outcome measurements related to symptom management and home deaths may be a critical foundation for enhancing the quality of rural palliative care.
College of Nursing, University of Saskatchewan, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada S7T 5E5. donna.goodridge@usask.ca
Donna
D
Goodridge
Wendy
W
Duggleby
D001291:Attitude of Health Personnel; D017598:Efficiency, Organizational; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D036301:Qualitative Research; D011787:Quality of Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D012449:Safety; D012525:Saskatchewan