Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Palliative Care Experiences of Adults Living in Regional and Remote Areas of Australia: A Literature Review

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Palliative Care Experiences of Adults Living in Regional and Remote Areas of Australia: A Literature Review

Article excerpt

Introduction

Compared with their metropolitan counterparts, regional and remote areas of Australia are often disadvantaged in terms of access across a range of healthcare services with palliative care services an area particularly affected (Australian Nursing & Midwifery Federation [ANMF], 2009; Department of Health [DoH], 2009). Australian palliative care services are concentrated predominantly in more densely populated areas, such as major cities, rather than regional and remote areas. The impact of reduced access to palliative care services on people living in regional and remote areas who have received or are currently receiving palliative care is poorly understood. Australian Government policy recommends palliative care services are optimised when provided within a patient's local community however, a significant proportion of palliative care adults living in regional and remote areas are required to travel into major cities to access appropriate palliative care (ANMF, 2009; DoH, 2009). On the whole the palliative care experiences of adults living in regional and remote areas of Australia are poorly understood.

As a direct result of poor access, palliative care patients in regional and remote areas are then forced to major cities to receive appropriate care, creating multi-faceted hardship (McGrath, Patton, McGrath, Olgivie, Rayner & Holewa, 2006; McGrath, 2007). Poor care coordination in regional and remote areas further hinders palliative care patients' ability to move quickly and freely from hospital- and community-based services to home and back again as their health and support needs change (Commonwealth of Australia, 2010; National Health and Medical Research Council [NHMRC], 2011). Whilst access to palliative care services depends upon geographic location, the experiences of palliative care patients may differ based solely on where they reside. To identify and address any inequities in palliative care provision and access, the experiences of palliative care patients living outside major cities need to be explored.

Government bodies acknowledge the need for increased palliative care services in regional and remote areas through the creation of key strategic objectives targeting poor service accessibility (DoH, 2009; NSW Ministry of Health, 2012). The World Health Organization [WHO] (1978) provides direction for such policy, by recommending strategies be formulated based on sustainable primary healthcare as part of comprehensive national health systems that work collaboratively. This is further supported by recommendations at a national level (ANMF, 2009). National health reform recommendations aim to refocus emphasis to health promotion, disease and injury prevention, and the elimination of health inequities for all Australian populations (ANMF, 2009). Despite the existence of such public health policy, evidence demonstrates regional and remote populations do not receive equitable access to palliative care services. Consequently, limited availability of services results in poor partnerships between healthcare teams (ANMF, 2009; Pearse, Mazevksa, & Sheehan, 2011).

In Australia palliative care services are provided to people with life-limiting illnesses through the National Palliative Care Strategy 2010: supporting Australians to live well at the end of life (Commonwealth of Australia, 2010); however, each state and territory has specified its own approach to palliative care in its jurisdiction (AIHW, 2014; Senate Community Affairs References Committee, 2012). This program provides palliation services in a variety of settings including the home, aged care facilities, palliative care units and hospitals (AIHW, 2014). The program guidelines recommend palliative care is most beneficial to the patient when provided within their local environment and community, yet there is limited evidence to support this (AIHW, 2014). Program guidelines also suggest patterns of care will differ between individuals and be dependent upon factors including geographic location, available services within the area, and the needs and wishes of the patient and their family (AIHW, 2014). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.