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Healthcare providers’ views on the transition between hospital and primary care in patients in the palliative phase: A qualitative description study

Journal of Pain and Symptom Management Mar 09, 2020

Flierman I, et al. - As inadequate handovers between hospital and home can result in adverse health outcomes, particularly in at-risk groups that also include patients at the end of life because of their complex health problems, frequent care transitions and involvement of many professionals, researchers here examined healthcare providers’ views and experiences concerning the transition from hospital to primary care in palliative care. In this descriptive qualitative study, they held three focus group discussions with 28 nurses and two focus groups with nine physicians. The data led to the emergence of the following themes: (1) lack of identification of and communication concerning the last phase of life; (2) incomplete and inadequate handover; and (3) ambiguity concerning responsibilities. Proper handovers and transitional processes in these vulnerable patients are emphasized by the professionals. A lack of recognition of the palliative phase and uncertainties about patient awareness are identified hindering the transition between hospital to primary care. Direct communication between professionals, which is a requirement, is lacking. Physical aspects are identified as the current primary focus of the handover itself where there is a necessity for psychosocial aspects as well. Furthermore, ambiguities concerning physicians’ liability for the patient appear to further hinder professionals in the transitional process. In view of these findings, they recommend improving knowledge and skills around identification of palliative requirements and communication with patients about the end of life, particularly in the hospital setting.
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