Spending one's last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of ...palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.
This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.
This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.
This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.
Domestic violence is recognized as a public health problem with a high prevalence in the general population. Healthcare professionals play an important role in the recognition and treatment of ...domestic violence. Hence, conducting research on factors that facilitate or inhibit appropriate actions by healthcare professionals is of the upmost importance. The objective of the study was to examine the relationship between healthcare professionals' attitudes toward the acceptability of domestic violence and their responses when dealing with victims of domestic violence.
The sample consisted of 322 healthcare professionals (physicians, dentists, nursing staff and other healthcare workers; 85.2% female), who completed a questionnaire, assessing their attitudes towards domestic violence, experience, behaviour and perceived barriers in recognizing and treating domestic violence in the health care sector. The study was cross-sectional and used availability sampling.
The results showed no significant differences in domestic violence acceptability attitudes when comparing groups of healthcare professionals who reported low or high frequency of domestic violence cases encounters. Furthermore, we found that domestic violence acceptability attitudes were negatively associated with action taking when the frequency of encounters with domestic violence cases was high and medium. However, the attitudes were not associated with action taking when the frequency of encounters with domestic violence cases was low.
The results highlight the important role of attitudes in action taking of healthcare professionals when it comes to domestic violence. This indicates the need for educational interventions that specifically target healthcare professionals' attitudes towards domestic violence.
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