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Adult palliative day-care services : an investigation of the factors influencing access to services using the case of a cancer network in the United Kingdom
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Greaves, Natalie (2012) Adult palliative day-care services : an investigation of the factors influencing access to services using the case of a cancer network in the United Kingdom. PhD thesis, University of Warwick.
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WRAP_THESIS_Greaves_2012.pdf - Submitted Version Download (3442Kb) | Preview |
Official URL: http://webcat.warwick.ac.uk/record=b2665729~S1
Abstract
Background: Literature indicates underutilization of Palliative Care Services in the UK, with possible
inequalities of access. These trends in underutilization are seen in Adult-Palliative Day-Care (APDC),
a Specialist Palliative Care Service delivered in the outpatient setting. However, gaps in knowledge
remain regarding if underutilization in APDC is real, and the identity and nature of the factors which
determine access.
Aim: The overall research question was “What are the factors which act to determine access to
APDC?”. Five sub-questions for exploration in the context of access were formulated relating to the:
perceived health care needs of users; the benefits of using APDC, and understandings of the role of
APDC as a palliative care service.
Methods: The study site was a cancer network in the Midlands of England which covered rural and
urban areas. It contained 5 APDC units, 3 Primary Care Trusts, and 3 Acute Care Trusts. Fifty semistructured
in-depth interviews were conducted with: 19 providers of APDC; 13 health professional
referrers; 11 palliative care patients who had used the service; and 7 of their carers. The reasons for
non-attendance for 149 patients who were referred to day-care but did not attend were also analysed.
Thematic analysis with constant comparison and content analysis were used to analyse transcripts and
document data respectively.
Results: Eighteen determinants of access were identified arising out of the characteristics of the:
potential service user (2), the health service or organization (9), and from interactions between
potential service users, the family, the wider society, and the health service (7). The study found that
utilization measures in APDC may not be accurately representing service use, as APDC units maybe
functioning at their maximum capacity while current calculation methods report underutilization.
Conclusion: New insights into accessing APDC are presented which and may have applications for
future policy and research.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > R Medicine (General) R Medicine > RT Nursing |
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Library of Congress Subject Headings (LCSH): | Palliative treatment -- Great Britain, Health services accessibility -- Great Britain -- Research, Terminal care -- Great Britain, Health facilities -- Utilization -- Case studies | ||||
Official Date: | June 2012 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Dale, Jeremy, 1958-; Ong, Paul; Lindenmeyer, Antje | ||||
Sponsors: | Barbados National Development Scholarship | ||||
Extent: | 387 leaves. | ||||
Language: | eng |
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