Palliative care use in the rural primary care setting

Abstract

Background: Palliative care is helpful to patients who are suffering from chronic or terminal illnesses. It can be initiated at any stage of the illness. Rural populations have an increased risk for not receiving palliative care and primary care providers have the ability to initiate palliative care services. Purpose: A doctoral project was completed to assess rural providers' perceived barriers, knowledge of, and comfort level with palliative care. Sample: Participants were rural primary care providers (n=138). Rural primary care providers were advanced care nurse practitioners(n=54), physicians assistants (n=30), and doctors of osteopathy/doctors of medicine (n=50). Methods: A survey was used for this project to explore knowledge of, comfort in, and barriers to providing palliative care in rural Montana. The survey was adapted from the End-of-Life Professional Caregiver Survey, the Physician Knowledge, Attitude, and Experience with Advance Care Panning, and The End of Life Care Survey. Results: Respondents generally felt comfortable with palliative care. Barriers documented included: lack of knowledge by healthcare professionals (54%), health care professionals' personal discomfort with palliative care (59%), and lack of understanding from patients and patents family about palliative care (80%). The results demonstrated that as the primary care providers were practicing in more rural areas, they felt their workplace did not provide resources. Conclusions: The results from this project demonstrated rural primary care providers felt they encountered barriers to palliative care and had a perceived lack of resources. This project and other research have indicated that rural dwellers are at an increased risk for not receiving palliative care and has identified reasons that it is not being utilized.