Physicians' perspectives of palliative care quality in nursing homes: a cross-sectional study.

Abstract

Background: Since physicians have primary responsibility for medical treatment, their perspectives of palliative care quality in nursing homes can provide important knowledge for service evaluation and enhancement in this context. However, few studies exist that include their perspectives.

Objectives: The aim was to investigate physicians' perspectives of the quality of palliative care in Norwegian nursing homes.

Methods: A cross-sectional study conducted between November 2022 and December 2023, which included 77 nursing home physicians (response rate 43.5%) in Norway. Data were collected using a questionnaire comprising questions about demographic variables and perceptions of quality of care, as measured by the short form of the instrument Quality from the Patients' Perspective for Palliative Care (QPP-PC), adapted for healthcare personnel. Descriptive analyses and Wilcoxon signed rank tests were performed.

Results: Nursing home physicians scored subjective importance of the care significantly higher than their perception of the quality of actual care received in the two dimensions; medical-technical competence and sociocultural atmosphere and for nine out of the 24 items and three out of seven additional symptom-specific questions. A need for improvement was identified in care areas such as symptom relief for pain, depression and anxiety, existential care, understanding patients' perspective, waiting time, individualized care, cooperation, and continuity.

Conclusion: The results show that provision of high-quality palliative care in nursing homes can be challenging and that the physicians identified several areas for improvement. The results can provide direction for future quality improvement. However, the findings need to be confirmed in a larger sample.