title: District nurse advocacy for choice to live and die at home in rural Australia: a scoping study.
abstract: BACKGROUND
  Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care.
  
  
  OBJECTIVE
  The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and die at home?, and identify gaps in the knowledge.
  
  
  METHODS
  Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings.
  
  
  RESULTS
  34 international studies revealed themes of 'the nursing relationship', 'environment', 'communication', 'support' and 'the holistic client centred district nursing role.
  
  
  CONCLUSIONS
  Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas.
  
  
  CONCLUSIONS
  It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered.
authors: La Trobe University, Australia fmreed@students.latrobe.edu.au.
authors: Frances M
authors: FM
authors: Reed
authors: La Trobe University, Australia.
authors: Les
authors: L
authors: Fitzgerald
authors: La Trobe University, Australia.
authors: Melanie R
authors: MR
authors: Bish
mesh_terms: D001315:Australia; D003657:Decision Making; D004993:Ethics, Nursing; D006801:Humans; D010166:Palliative Care / Q000941:ethics*; D010344:Patient Advocacy; D019035:Rural Health Services
keywords: Advocacy; community; district nursing; end-of-life; holistic; palliative