Evaluating the PalliSupport care pathway to improve palliative care and quality of life
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Background: Patients, families and healthcare professionals have experienced barriers in palliative care. To support patients and reduce these barriers, the PalliSupport care pathway was developed. However, since this care pathway was implemented for the first time, the experiences and perspectives of patients as well as the process of implementation are still unknown. It is important to understand how the PalliSupport care pathway influences outcomes and to gain insight into its implementation before carrying out the care pathway. Aim: To explore the experiences and perspectives of patients in the palliative phase of the PalliSupport care pathway and to provide insight into what extent the components, according to study protocol, of the PalliSupport care pathway were implemented. Methods: A convergent parallel mixed-method design was conducted. Qualitative and quantitative data were collected through semi-structured interviews, questionnaires, study records and electronic health records. Results: After conducting interviews with patients, it was discovered they had different expectations of the conversations and their hospital care or they had not thought about end-of-life. Furthermore, expectations of PalliSupport changed in the hospital and at home. Some patients thought the hospital was the right place to talk about palliative care, while other patients did not remember the conversations. In total, 29 components of the PalliSupport care pathway were implemented and measured. The extent of implementation for these components ranged from 0.0% to 94.4%. In the lowest component, no district nurse was invited for a warm handover in the hospital. In the highest component, the general practitioners received a medical handover. Conclusion: A first overview is given of the experiences and perspectives of patients and the implemented components of the PalliSupport care pathway. It is important to accommodate the wishes of patients and to conduct in-depth research into some components.