Process Evaluation of the Regional Referral Clinical Pathway for Home-Based Palliative Care and Outreach Program: A Questionnaire Survey of the Medical Staff and Bereaved Families.
Nozomu Murakami, Kouichi Tanabe, Tatsuya Morita and 5 others
PMID 34872375WHAT IT FOUND
Staff and families in Japanese home palliative care found outreach and a shared pathway useful for communication and reduced burden, but some reported stress from multiple visits and duplicated records.
These are perceptions, not proof.
Key findings
01Staff and family responses rated outreach items about communication and reduced burden highly.
02Staff responses showed RRCP-HPC communication and information-sharing factors were moderately correlated with several usefulness outcomes.
03Negative impact factors were reported by staff and families but were not moderately or strongly correlated with outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The outreach program came from one hospital in one Japanese region, so results may not apply elsewhere. Only 84 staff and 67 bereaved families responded; response rates were 51.3% per institution and 42.4% for families, so responders may not represent non-responders. Families were surveyed a median 977 days after death, so memories may have changed. Staff and families were asked about perceptions of usefulness, not directly measured patient symptoms or survival outcomes. Other concurrent interventions, including PEACE education and other care, were in place, so the effect of outreach or RRCP-HPC alone cannot be separated. Questionnaires were sent in fixed numbers to institutions, and the total number of eligible providers was unknown, creating possible selection bias.
Declared interests
The authors declared no potential conflicts of interest. The study was supported by a grant from the Japan Society for the Promotion of Science.
The easy way to misread this
Do not conclude that outreach visits or the shared pathway caused home deaths without difficulties. The paper reports staff and family perceptions and correlations, and other concurrent interventions were used, so it does not prove the program works.