Research study into the educational, training and support needs of general practitioners in palliative care: Reflections on interviews conducted with carers

Aim: To assess the perceptions of recently bereaved carers regarding the quality of palliative care provided in the community setting by the patient’s GP.

Method: Carer perceptions of the palliative care received by their loved-ones is important in determining the quality of community based palliative care provided by GPs. In this study carers were invited to talk about their experiences of that care. Half the carers were self-selected in that they responded to an advertisement in a local newspaper and half the carers were approached through the deceased patient’s GP. Carers were recruited across three target populations - indigenous and transcultural communities, rural and remote communities and patients in home-based and residential aged care facilities. Carers were interviewed face-to-face, at a venue of their choice, using a semi-structured framework. The framework was based upon the five quality domains, physical, psychological, social, spiritual and cultural, that underpin specialist palliative care practice. Interviews were taped and transcribed verbatim. Transcripts were then analysed thematically.

Findings: Carers are often unable to fully define their palliative care needs because the palliative experience is intensely unfamiliar, unstable and emotionally distressing. Nonetheless carers can easily articulate emotional responses to that experience. There were many common issues raised across the target populations. For instance, carers volunteered statements about the importance of relationships with GPs that extended beyond the patient’s disease, the GPs availability, the necessity for well co-ordinated community services and the availability of bereavement care. These themes will be discussed as well as population specific findings.