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P-123 Benchmarking the provision of palliative rehabilitation within adult uk hospices
  1. Penny Wosahlo1 and
  2. Matthew Maddocks2
  1. 1Farleigh Hospice, Independent Living Team, Chelmsford, UK
  2. 2Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College

Abstract

Background Rehabilitation is an important part of a holistic palliative care approach. Evidence for palliative rehabilitation is limited leading to large variation in practice and uncertainty about how best to deliver care.

Aim To benchmark the provision of palliative rehabilitation, exploring the level and range of allied health professional (AHP) staffing, interventions, settings and service evaluation.

Methods National survey of rehabilitation practice within the adult voluntary hospice sector using a 68 item online questionnaire. Most questions were closed with multiple, non-ranked options. Ordinal data were summarised by median (inter-quartile range, IQR). Frequency counts and percentages with 95% confidence intervals (95% CI) were calculated for overall responses to items.

Results Forty-one hospices across the United Kingdom participated, serving populations ranging from <50,000 to >1 million with overall staffing from <20 to >60 full time equivalent employees. All but one hospice considered that they carried out rehabilitation. Hospices employed a median of 1−2 AHPs, most often a physiotherapist, who led rehabilitation services in 78% (95% CI 63, 88) of hospices. The level of AHP staffing did not relate to overall staffing (p = 0.10) or the population served (p = 0.22). A wide range of interventions were offered, most frequently on a one-to-one basis and less frequently within a group, including interventions suited to a group format, e.g. exercise. Goal setting was used by 93% (95% CI 81, 98) of respondents, but the process and outcome were rarely documented. Only 37% (95% CI 24, 52) of respondents regularly used outcome measures.

Conclusions These data provide a benchmark to assess provision of palliative rehabilitation in the hospice setting. The large variation in practice, together with the lack of evaluation through goal setting or outcome measurement, highlights the need for evidence-based development in this aspect of care.

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