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Advance care planning in rural New South Wales from the perspective of general practice registrars and recently fellowed general practitioners
Author(s) -
Littlewood Jean,
Hinchcliff Reece,
Lo Winston,
Rhee Joel
Publication year - 2019
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12525
Subject(s) - thematic analysis , nursing , medicine , advance care planning , rural area , general practice , vocational education , qualitative research , health care , perspective (graphical) , rural health , family medicine , psychology , palliative care , political science , sociology , social science , pedagogy , pathology , artificial intelligence , computer science , law
Objective This study examined advance care planning as delivered by general practice registrars and recently fellowed GPs in New South Wales rural settings. The facilitators and barriers to advance care planning uptake in these areas were investigated, as well as the state of general practice training on advance care planning. Design Qualitative descriptive methodology, involving semi‐structured face‐to‐face and telephone interviews. Setting Primary care. Participants General practice registrars and recently fellowed GP s in New South Wales rural settings. Definition of rural using the Australian Standard Geographical Classification ‐ Remoteness Area. Thirteen participants were included in the study. Main outcome measures Thematic analysis of interview transcripts elucidated key issues emerging from participants' accounts. Results Key barriers included doctor‐dependent uptake, demands on doctor's time and the limited relevant resources available. Facilitators recognised were patient control in end‐of‐life care and long‐standing relationships between GP s and their patients. Uptake among patients was low, and minimal training on advance care planning reported. Conclusion The lack of training opportunities in advance care planning during vocational training, especially when combined with the essential role played by rural GP s in initiating advance care planning and providing end‐of‐life care, appears to be a major problem that might contribute to poor uptake among patients in rural areas. This study demonstrated, however, the significant benefits that advance care planning could bring in patients living in rural communities if delivered effectively. Given that rural GP s face a number of barriers to providing routine health care, these results highlight an important need to provide GP s and rural communities with support, education, incentive, better administrative tools, options and greater awareness of advance care planning.