'When a patient chooses to die at home, that's what they want… comfort, home': Brilliance in community-based palliative care nursing.

brilliant care community health knowledge translation palliative care positive organisational scholarship teleological analysis video-reflexive ethnography

Journal

Health expectations : an international journal of public participation in health care and health policy
ISSN: 1369-7625
Titre abrégé: Health Expect
Pays: England
ID NLM: 9815926

Informations de publication

Date de publication:
Aug 2023
Historique:
revised: 25 03 2023
received: 15 07 2022
accepted: 14 05 2023
medline: 17 7 2023
pubmed: 10 6 2023
entrez: 10 6 2023
Statut: ppublish

Résumé

To redress the scholarly preoccupation with gaps, issues, and problems in palliative care, this article extends previous findings on what constitutes brilliant palliative care to ask what brilliant nursing practices are supported and promoted. This study involved the methodology of POSH-VRE, which combines positive organisational scholarship in healthcare (POSH) with video-reflexive ethnography (VRE). From August 2015 to May 2017, inclusive, nurses affiliated with a community health service who delivered palliative care, contributed to this study as co-researchers (n = 4) or participants (n = 20). Patients who received palliative care (n = 30) and carers (n = 16) contributed as secondary participants, as they were part of observed instances of palliative care. With a particular focus on the practices and experiences that exceeded expectations and brought joy and delight, the study involved capturing video-recordings of community-based palliative care in situ; reflexively analysing the recordings with the nurses; as well as ethnography to witness, experience, and understand practices and experiences. Data were analysed, teleologically, to clarify what brilliant practices were supported and promoted. Brilliant community-based palliative care nursing largely involved maintaining normality in patients' and carers' lives. The nurses demonstrated this by masking the clinical aspects of their role, normalising these aspects, and appreciating alternative 'normals'. Redressing the scholarly preoccupation with gaps, issues, and problems in palliative care, this article demonstrates how what is ordinary is extraordinary. Specifically, given the intrusiveness and abnormalising effects of technical clinical interventions, brilliant community-based palliative care can be realised when nurses enact practices that serve to promote a patient or carer to normality. Patients and carers contributed to this study as participants, while nurses contributed to this study as co-researchers in the conduct of the study, the analysis and interpretation of the data, and the preparation of the article.

Identifiants

pubmed: 37296530
doi: 10.1111/hex.13780
pmc: PMC10349220
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1716-1725

Subventions

Organisme : Agency for Clinical Innovation
Organisme : Western Sydney University

Informations de copyright

© 2023 The Authors. Health Expectations published by John Wiley & Sons Ltd.

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Auteurs

Ann Dadich (A)

School of Business, Western Sydney University, Parramatta, New South Wales, Australia.

Michael Hodgins (M)

School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Kerrie Womsley (K)

Palliative Care Service, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.

Aileen Collier (A)

Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

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