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Palliative home care for cancer patients in DK - with a particular focus on the primary care sector,
GPs and community nurses


Mette Asbjoern Neergaard  


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Accepted by: Faculty of Health Sciences Aarhus University
Defended on: May 29, 2009
Official opponents: Bo Christensen , Mogens Groenvold , Marianne Ewertz
Tutors: Frede Olesen , Jens Sondergaard , Anders Bonde Jensen

Published in the PhD Database: July 10, 2009


English abstract
This thesis is based on a mixed method study conducted from 2005 to 2008. The thesis is based on five papers and focuses on palliative care for cancer patients at home.
Introduction
Approximately forty percent of all cancer deaths in Denmark occur in the patients homes, but most patients and their relatives wish terminal care and death to take place at home. There is a need for a deeper insight into delivery of good palliative home care.
Aims
The overall research questions of this thesis were:
Research questions: Which wishes to the function and organisation of palliative care at home exist, and which factors are associated with experiences of successful and unsuccessful palliative pathways?
The specific aims of this thesis were divided in the following:
1: To analyse experiences and preferences of bereaved relatives of terminally ill cancer patients in a primary care setting to explore barriers and facilitators for delivery of good palliative home care (Paper 1).
2: To illuminate involved health-professionals experiences and views on interprofessional cooperation in basic level palliative home-care (Paper 2).
3: To describe cancer patients in palliative home care in relation to demographic characteristics, palliative pathway, degree of general practitioner involvement, and to examine the association between home death and general practitioner involvement (Paper 3).
4: To examine associations between the bereaved relatives evaluation of palliative pathways, place of death and general practitioners involvement (Paper 4).
5: To examine the association between the bereaved relatives evaluation of palliative pathways and the place of death and the community nurses involvement (Paper 5).



Danish abstract
Dansk abstract
Den palliative indsats for cancer patienter i Danmark ¿ med et særligt fokus på primærsektoren,
praktiserende læger og hjemmesygeplejersker.
Et mixed-method-studie blev foretaget fra 2005 til 2008 omhandlende denpalliative indsats for cancer patienter i eget hjem.
Baggrund
Omkring en fjerdedel af alle cancer dødsfald foregår i patientens eget hjem, men langt de fleste
patienter og deres pårørende ønsker, at patienten plejes og dør hjemme. Der er et behov for at opnå viden om erfaringer, barrierer og facilitatorer for hjemmedød .
Formål
Forskningsspørgsmål: Hvilke forslag til forbedringer og ønsker til funktion og organisation af
palliativ hjemmebehandling er der og hvilke faktorer er associerede med oplevelsen af et succesfuldt palliativt forløb?
De specifikke formål med ph.d. tesen var inddelt i de følgende formål:
1: At analysere erfaringer og ønsker fra efterladte pårørende til cancer patienter for at undersøge
barrierer og facilitatorer for at opnå et godt palliativt forløb i forhold til primærsektoren (Artikel 1).
2: At analysere involverede sundhedsprofessionelles erfaringer og syn på tværfaglig samarbejde
på basis niveau af palliativ hjemmepleje (Artikel 2).
3: At beskrive døende cancer patienters demografi, det palliative forløb og involvering af den
praktiserende læge, samt at analysere associationen mellem hjemmedød og involvering af den
praktiserende læge (Artikel 3).
4: At analysere associationen mellem den efterladte pårørendes evaluering af forløbet og
involvering af den praktiserende læge og dødssted (Artikel 4).
5: At analysere associationen mellem den efterladte pårørendes evaluering af forløbet og dødssted
og involvering af hjemmesygeplejersken (Artikel 5).