| Abstract [eng] |
Viktorija Mickevičienė. Master's thesis in advanced practice nursing: "The impact of palliative care at home on the patient's quality of life: a nurse's perspective". Head of work prof. Dr. Natalja Istomina, job consultant jn. assistant Marius Čiurlionis. Department of Nursing, Institute of Health Sciences, Faculty of Medicine, Vilnius University. Introduction. The ageing population and the increasing incidence of incurable diseases are a reason to improve the quality and accessibility of palliative care services at home, and to develop a new approach to palliative care services in patients' homes. Few studies have been carried out on palliative care at home and staff knowledge and information in this field is scarce, and more research is needed to understand the impact of palliative care on patients' quality of life. Objective - To determine the impact of palliative care at home on the patient's quality of life after assessing the nurse's perspective. Methods and material. An analysis of the scientific literature and a qualitative study were performed. The interview schedule developed by the author was used to collect the data and semi-structured interviews were conducted. The approval of the Ethics Commission of Vilnius University, Faculty of Medicine, Department of Nursing (No. KT-102) was obtained for conducting the study. 8 nurses who provide palliative care services at home were interviewed. The research data were processed using the content analysis method. Results. From nurse's perspective, home palliative care services emphasise the diversity of services, but often the effectiveness of these services is undermined by problems of inadequate human resources and, in some cases, insufficient funding for visits, thus failing to provide for the needs of all patients, and thus negatively impacting on their quality of life. The discussion of the individual factors has shown that they are very closely interlinked, as physical factors lead to the emergence of psycho-emotional factors and, consequently, to the emergence of social factors. Conclusions. From nurse's perspective, the results of this study showed that the current provision of palliative care at home has a superficial effect on the patient's quality of life. Home palliative care team members have a significant impact in contributing to improving the quality of life of patients, but the problems encountered in the delivery of these services and the human factors involved have a negative impact on patients' quality of life. Recommendations. 1) Increase access to services by expanding home palliative care teams. To ensure the provision of palliative care services at home not only during the day, but also at night. 2) Organize internal training for family doctors and nurses about home palliative care services, provision of these services, availability, recipients. Keywords: palliative care services at home, patients, nurses, quality of life. |
