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1.
  • Böling, Susanna, et al. (författare)
  • No ordinary consultation : a qualitative inquiry of hospital palliative care consultation services
  • 2020
  • Ingår i: Journal of Health Organization and Management. - : Emerald Group Publishing Limited. - 1477-7266. ; 34:6, s. 621-638
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose – Considering the great need for palliative care in hospitals, it is essential for hospital staff to havepalliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care.However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need forfurther knowledge about the process of palliative consultations. The purpose of this study therefore was toexamine how palliative consultations in hospitals are practised, as perceived by consultants and health careprofessionals on receiving wards.Design/methodology/approach – Focus groups with palliative care consultation services, health carepersonnel from receiving wards and managers of consultation services. Interpretive description and constantcomparative method guided the analysis.No ordinaryconsultationThe authors would like to thank participating colleagues for sharing their knowledge and experiencesabout palliative consultations.Ethics approval and consent to participate: The project received ethical approval from the SwedishEthical Review Authority, No. 809–16. Informed consent preceded participation for all of the participants.Consent for publication: Not applicable.Availability of data and material: The datasets generated and analysed during the current study are notpublicly available due to the inclusion of potentially sensitive individual data about health status. Theethical approval includes a statement that the data will be kept in a private repository but are availablefromthe corresponding author on reasonable request.Funding: Sahlgrenska Academy at the University of Gothenburg.Authors' contributions: JO, HB and JB planned the study. All authors conducted focus group €interviews. Analysis and interpretation of focus group data was performed by SB with support from JO, €HB and JB. SB wrote the first draft of the manuscript, JO, HB and JB commented on the manuscript and €contributed to the final version. The final manuscript was read and approved by all authors.Competing interests: The authors declare that they have no competing interests.The current issue and full text archive of this journal is available on Emerald Insight at:https://www.emerald.com/insight/1477-7266.htmReceived 14 April 2020Revised 24 June 2020Accepted 2 July 2020Journal of Health Organization andManagement© Emerald Publishing Limited1477-7266DOI 10.1108/JHOM-04-2020-0130Findings – Variations were seen in several aspects of practice, including approach to practice and representedprofessions. The palliative consultants were perceived to contribute by creating space for palliative care,adding palliative knowledge and approach, enhancing cooperation and creating opportunity to amelioratetransition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultationservices utilised proactive practices that took the initiative in relation to the receiving wards.Originality/value – A lack of policy and divergent views on how to conceptualise palliative care appeared tobe associated with variations in consultation practices, tentative approaches and a bottom-up drivendevelopment. This study adds knowledge, implying theoretical transferability as to how palliative careconsultations can be practised, which is useful when designing and starting new consultation services.
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2.
  • Böling, Susanna, et al. (författare)
  • Rethinking Consultation - Investigating the Perceived Work Models of a Palliative Consultation Team
  • 2018
  • Ingår i: Palliative Medicine : A Multiprofessional Journal. Vol. 32, Suppl. 1. Abstract PO38. - : SAGE Publications. - 0269-2163 .- 1477-030X.
  • Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
    • Background: Previous research has shown that palliative consultation in hospital contexts sometimes face multifaceted challenges. Possibly creat- ing barriers between the consulting team and patients in need of palliative care. Hence, there is a need to consider how we implement and perform palliative consultation to inform future initiatives. This study is part of an ongoing project with the aim to analyse the discourse around implement- ing palliative care in a hospital context. Aim: The aim of this study was to identify and analyse various work models applied in a hospital context by a palliative consultation team. Method: Repeated focus group discussions with a palliative consultation team and its managers. A total of six focus group discussions were held from April 2016 to June 2017. The focus groups were audio recorded and transcribed verbatim. The data was read and analysed; identifying and categorising different work models. Result: According to what was expressed in the focus groups there were variations in how the consultation team operated in different hospital units and wards. Consulting as a team, consisting of a nurse, social worker and physician, was emphasised. One of the significant features was that they visited several wards on a weekly basis without receiving formal referrals beforehand. Although varying in form, the visits shared the function of being a forum for the wards to raise questions regarding palliative care relating to specific patients with palliative needs. Furthermore, during the introduction of consultation in some of the wards, the consultation team chose to designate time where a nurse from the team were present in the ward and among other things; identified patients with palliative care needs together with the ward staff and paved the way for the weekly palliative consultation.
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