Paramedics providing palliative care at home: A mixed-methods exploration of patient and family satisfaction and paramedic comfort and confidence

Alix J.E. Carter, Marianne Arab, Michelle Harrison, Judah Goldstein, Barbara Stewart, Mireille Lecours, James Sullivan, Carolyn Villard, Wilma Crowell, Katherine Houde, Jan L. Jensen, Kathryn Downer, Jose Pereira

Research output: Contribution to journalArticlepeer-review

63 Citations (Scopus)

Abstract

Objective Paramedics Providing Palliative Care at Home was launched in two provinces, including a new clinical practice guideline, database, and paramedic training. The aim of this study was to evaluate patient/family satisfaction and paramedic comfort and confidence.Methods In Part A, we gathered perspectives of patients/families via surveys mailed at enrolment and telephone interviews after an encounter. Responses were reported descriptively and by thematic analysis. In Part B, we surveyed paramedics online pre- and 18 months post-launch. Comfort and confidence were scored on a 4-point Likert scale, and attitudes on a 7-point Likert scale, reported as the median (interquartile range [IQR]); analysis with Wilcoxon ranked sum/thematic analysis of free text.Results In Part A, 67/255 (30%) enrolment surveys were returned. Three themes emerged: fulfilling wishes, peace of mind, and feeling prepared for emergencies. In 18 post-encounter interviews, four themes emerged: 24/7 availability, paramedic professionalism and compassion, symptom relief, and a plea for program continuation. Thematic saturation was reached with little divergence. In Part B, 235/1255 (18.9%) pre- and 267 (21.3%) post-surveys were completed. Comfort with providing palliative care without transport improved post launch (p = < 0.001) as did confidence in palliative care without transport (p = < 0.001). Respondents strongly agreed that all paramedics should be able to provide basic palliative care.Conclusions After implementation of the multifaceted Paramedics Providing Palliative Care at Home Program, paramedics describe palliative care as important and rewarding. The program resulted in high patient/family satisfaction; simply registering provides peace of mind. After an encounter, families particularly noted the compassion and professionalism of the paramedics.

Original languageEnglish
Pages (from-to)513-522
Number of pages10
JournalCanadian Journal of Emergency Medicine
Volume21
Issue number4
DOIs
Publication statusPublished - Jul 1 2019
Externally publishedYes

Bibliographical note

Funding Information:
We are grateful to the Canadian Partnership Against Cancer for funding this work and to Pallium Canada for the development of LEAP-Paramedic.We would like to thank the Advisory Group and the paramedics of Nova Scotia and PEI. This work has been presented as a research abstract at NAEMSP 2018 in San Diego, California.

Funding Information:
ship Against Cancer for funding this work and to Pallium Canada for the development of LEAP-Paramedic. We would like to thank the Advisory Group and the paramedics of Nova Scotia and PEI. This work has been presented as a research abstract at NAEMSP 2018 in San Diego, California.

Publisher Copyright:
© Canadian Association of Emergency Physicians 2019.

ASJC Scopus Subject Areas

  • Emergency Medicine

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