Background In order to transform end of life care (Leadbeater & Garber, 2010) these two studies look at the implementation of rehabilitative palliative care in a hospice in-patient unit (IPU).
Aim Using action research, to integrate rehabilitative palliative care identifying the facilitators and barriers from the health care professionals’ (HCPs) perspective.
Methods Implementing rehabilitative palliative care, PhD.
Using participatory action research (PAR), to plan and implement a rehabilitative approach in an IPU. Concurrent analysis was used to inform the PAR cycles and thematic analysis (Braun & Clarke, 2013) was used to identify the facilitators and barriers.
Rehabilitative palliative care in hospices: The HCP perspective, MSc.
Using exploratory qualitative interviews, to explore the views and experiences of HCPs working in hospices on rehabilitative palliative care. Iterative categorisation technique (Neale, 2016) was used to develop key themes.
Results Due to strategies undertaken through PAR, rehabilitative palliative care was implemented into practice on the IPU and acknowledged throughout the hospice as a valid approach to care. A co-operative inquiry group of nine people (clinical, support staff and volunteers) was responsible for collectively developing an understanding of rehabilitative palliative care and planning how to implement it. Engagement of senior managers and the wider MDT were key change facilitators, as was a comprehensive education programme for staff and volunteers. Both research projects identified a number of organisational and operational challenges in terms of: concept, lay/external perceptions, alignment with current models of care and a tradition of ‘over-caring’, risk aversion, strategic direction, senior/management engagement, insufficient time and/or resources, variable condition of patients, poor team working/communication.
Conclusion PAR can be used to integrate rehabilitative palliative care, and HCPs want to engage with and implement the concept in their practice. The combined results of these two research studies show how research can drive a change in practice successfully through a top down and bottom up approach.
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