title: The nature and importance of quality of therapeutic relationships in the delivery of palliative care to people with intellectual disabilities.
abstract: BACKGROUND
  The importance of the therapeutic relationship in the delivery of palliative care is well recognised. Little has been published on the nature or quality of relationships formed between staff and patients with intellectual disabilities despite case reports suggesting that difficulties exist in providing palliative care to this group.
  
  
  OBJECTIVE
  This study was part of a project that aimed to describe the delivery of palliative care to people with intellectual disabilities in a region of Ireland and to conduct a corporate assessment of palliative care need. We detail findings that explore the nature and importance of the quality of relationship in the delivery of care.
  
  
  METHODS
  91 staff from palliative care and intellectual disability services participated in 16 focus groups.
  
  
  RESULTS
  Staff valued their relationships with service users, and felt that the quality of their relationship affected its therapeutic potential. Participants described factors fundamental to the development of quality relationships. Palliative care and intellectual disability staff commented on the importance of trust, of continuity of relationship and of knowing the individual. However, palliative care staff admitted to difficulties in these areas when providing care to people with intellectual disabilities. It appeared that quality of care was affected in situations where staff failed to form authentic relationships.
  
  
  CONCLUSIONS
  This study adds to our knowledge of the processes of delivery of care to people with intellectual disabilities. The description of difficulties experienced by palliative care staff gives us an opportunity to develop strategies to improve the quality of services provided.
authors: Department of Palliative Care, St Francis Hospice, Dublin 5, Ireland.
authors: Karen
authors: K
authors: Ryan
authors: School of Psychology, University College Dublin, Dublin, Ireland.
authors: Suzanne
authors: S
authors: Guerin
authors: School of Health & Science, Dundalk Institute of Technology, Dundalk, Ireland.
authors: John
authors: J
authors: McEvoy
mesh_terms: D001291:Attitude of Health Personnel; D003695:Delivery of Health Care / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008607:Intellectual Disability / Q000628:therapy*; D008297:Male; D020380:Needs Assessment; D010166:Palliative Care / Q000458:organization & administration* / Q000592:standards; D011369:Professional-Patient Relations
keywords: Communication; Intellectual Disability; Learning Disability; Palliative Care; Patient Professional Relationships