Awareness as a dimension of health care access: exploring the case of rural palliative care provision in Canada

被引:12
作者
Pugh, Arlanna [1 ]
Castleden, Heather [1 ,2 ]
Giesbrecht, Melissa [3 ]
Davison, Colleen [1 ]
Crooks, Valorie [4 ]
机构
[1] Queens Univ, Dept Publ Hlth Sci, Kingston, ON, Canada
[2] Queens Univ, Dept Geog & Planning, Kingston, ON, Canada
[3] Univ Victoria, Inst Aging & Lifelong Hlth, Victoria, BC, Canada
[4] Simon Fraser Univ, Dept Geog, Burnaby, BC, Canada
关键词
access to health care; awareness; palliative care; MENTAL-HEALTH; SERVICES; ISSUES;
D O I
10.1177/1355819619829782
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objectives In Canada, the rural elderly population is increasing in size, as is their need for palliative care services in these settings. This analysis aims to identify awareness-associated barriers to delivering rural palliative care services, along with suggestions for improving service delivery from the perspective of local health care providers. Methods A total of 40 semi-structured interviews with various formal and informal health care providers were conducted in four rural and/or remote Canadian communities with limited palliative care resources. Interview data were thematically coded using Penchansky and Thomas' five dimensions of access (i.e. availability, (geographic) accessibility, accommodation, acceptability and affordability). Saurman's recently added sixth dimension of access - awareness - was also identified while coding and subsequently became the primary focus of this analysis. Results Identified barriers to palliative care awareness and suggestions on how to enhance this awareness, and ultimately palliative care delivery, corresponded with three key themes arising from the data: limited palliative care knowledge/education, communication and coordination. Participants recognized the need for more palliative care education, open lines of communication and better coordination of palliative care initiatives and local resources in their communities. Conclusions These findings suggest that identifying the barriers to palliative care awareness in rural communities may be foundational to addressing barriers to the other five dimensions of access. A thorough understanding of these three areas of awareness knowledge, communication and coordination, as well as the connections between them, may help enhance how rural palliative care is delivered in the future.
引用
收藏
页码:108 / 115
页数:8
相关论文
共 29 条
[1]   Access to mental health and psychosocial services in Cambodia by survivors of trafficking and exploitation: a qualitative study [J].
Aberdein, Charlotte ;
Zimmerman, Cathy .
INTERNATIONAL JOURNAL OF MENTAL HEALTH SYSTEMS, 2015, 9
[2]  
ANDERSEN RM, 1983, HEALTH SERV RES, V18, P49
[3]   The concept and usefulness of ambulatory care sensitive conditions as indicators of quality and access to primary health care [J].
Ansari, Zahid .
AUSTRALIAN JOURNAL OF PRIMARY HEALTH, 2007, 13 (03) :91-110
[4]  
Braun V., 2012, Qualitative methods in mental health and psychotherapy: A guide for students and practitioners, P55, DOI [10.1007/978-981-10-5251-4103, DOI 10.1007/978-981-10-5251-4103, 10.1007/978-1-4614-5583-7_311, DOI 10.1037/13620-004, 10.1080/17439760.2016.1262613, DOI 10.1007/978-981-10-2779-6103-1, 10.1007/978-981-10-2779-6_103-1]
[5]   Palliative care as an International human right [J].
Brennan, Frank .
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 2007, 33 (05) :494-499
[6]  
Canadian Hospice Palliative Care Association, 2014, CHPCA FACT SHEET HOS
[7]   Providers' perceptions of Aboriginal palliative care in British Columbia's rural interior [J].
Castleden, Heather ;
Crooks, Valorie A. ;
Hanlon, Neil ;
Schuurman, Nadine .
HEALTH & SOCIAL CARE IN THE COMMUNITY, 2010, 18 (05) :483-491
[8]   "It's not necessarily the distance on the map ... ": Using place as an analytic tool to elucidate geographic issues central to rural palliative care [J].
Castleden, Heather ;
Crooks, Valorie A. ;
Schuurman, Nadine ;
Hanlon, Neil .
HEALTH & PLACE, 2010, 16 (02) :284-290
[9]   Refining a Location Analysis Model Using a Mixed Methods Approach: Community Readiness as a Key Factor in Siting Rural Palliative Care Services [J].
Crooks, Valorie A. ;
Schuurman, Nadine ;
Cinnamon, Jonathan ;
Castleden, Heather ;
Johnston, Rory .
JOURNAL OF MIXED METHODS RESEARCH, 2011, 5 (01) :77-95
[10]  
Dandy K, 2008, RURAL SMALL TOWN CAN, V7