Developing rural palliative care: a conceptual model

• Main Author: Kelley, Mary Louise Nickerson
• Other Authors: Chappell, Neena L.
• Language: English; en
• Published: 2009
• Subjects: rural health services; Canada; palliative treatment; UVic Subject Index::Humanities and Social Sciences
• Online Access: http://hdl.handle.net/1828/1960

The goal of the dissertation research was to understand and conceptualize the process of developing palliative care in rural communities from the perspective of health care providers. Canadian research about rural palliative care is timely and important. Since 1995, two Senate committees and two national reviews of the health care system have called for increased access to palliative care throughout Canada. Several provinces have subsequently launched strategies aimed at improving access to palliative or end-of-life care; however practical models for developing rural programs are lacking. This research contributes to improving access to palliative care for people dying in rural Canada by generating practical and theoretical knowledge about developing local programs in rural communities. Data were transcripts of nine group interviews of interdisciplinary providers involved in providing rural palliative care in six different provinces and territories of Canada. The outcome of the research was an original model called Developing Rural Palliative Care that conceptualized four sequential and incremental phases of development: antecedent community conditions, a catalyst, creating the team and growing the program. The model articulates the major processes and activities within each phase. Throughout the developmental process, the nature of the rural community both supported the work of providers and created their challenges. Working together and being community-focused emerged as the overarching keys to success. Most of the palliative care work utilized existing local resources. Throughout the analysis, the research used ideas of community capacity development as sensitizing concepts. The research concluded that developing palliative care can be understood and represented as a process of community capacity development, offering an innovative way of thinking about developing health services that can guide the process of implementing palliative care services. Ultimately, the research findings suggest that access to palliative care can be improved in rural communities by creating local palliative care teams and supporting them to develop services.