title: The role of UK district nurses in providing care for adult patients with a terminal diagnosis: a meta-ethnography.
abstract: OBJECTIVE
  To explore the role of UK district nurses in providing care for adult patients with a terminal diagnosis by reviewing qualitative research.
  
  
  METHODS
  Meta-ethnography was used to conduct the synthesis.
  
  
  METHODS
  CINAHL, MEDLINE and British Nursing Index (BNI) were searched comprehensively for primary research relating to the role of UK district nurses in palliative care.
  
  
  METHODS
  The abstracts and titles of 700 papers were screened against inclusion criteria, of these 97 full papers were appraised. Some 24 studies reported in 25 papers were selected for inclusion in the synthesis.
  
  
  RESULTS
  In total, five key themes were identified: valuing the role; practical role; relationships with patients and families; providing psychological support; and role uncertainty. Further synthesis yielded two 'lines of argument'. The concept of the 'expert friend' argues that the atypical relationship district nurses cultivate with patients underpins district nurses' provision of palliative care and profoundly influences the nature of psychological support given. Secondly, the concept of 'threat and opportunity' encapsulates the threat district nurses can feel to their traditional role in palliative care through changing health and social policy, while recognising the benefits that access to specialist knowledge and better training can bring.
  
  
  CONCLUSIONS
  The findings have implications for understanding the motivators and barriers experienced by district nurses delivering palliative care in a time of unprecedented change to community health services.
authors: Community Staff Nurse, York Teaching Hospitals NHS Foundation Trust, York, UK.
authors: John
authors: J
authors: Offen
mesh_terms: D000328:Adult; D000884:Anthropology, Cultural; D006801:Humans; D024802:Nurse's Role; D009740:Nursing Staff; D013727:Terminal Care; D006113:United Kingdom
keywords: Community heath nursing; District nurse; Meta-ethnography; Palliative care