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Biomedical subjects

Keri Thomas

Publications and source records attributed to Keri Thomas.

6 recordsLinked to original sources
PubMed2006

How do people with cancer wish to be cared for in primary care? Serial discussion groups of patients and carers.

BACKGROUND: In most economically developed countries, patients, their informal and professional carers and policy makers are calling for more care in the community. OBJECTIVES: To involve patients with cancer, and their carers, in designing a framework for providing effective cancer care in primary care. METHODS: Two discussion groups comprising 18 people with current cancer and carers met monthly over a year in the south of Scotland. RESULTS: Patients with cancer and their carers identified five key times in the cancer journey as being especially significant from their perspective: around diagnosis, during treatment, after discharge, at recurrence and the final weeks. At each key time, there were five major issues of concern: information, communication, equity, a holistic approach and patient-centred care. Using these, the group members developed a checklist of recommended interventions for each stage in the illness trajectory and suggested how they might be implemented in primary care. Proactive and ongoing contact, if wished by the patient, was considered the central plank of cancer care in the community. CONCLUSIONS: Patients with cancer and their carers believe that there is an important and unique role for primary care in offering continuity of care and information that is patient-centred and holistic, throughout the cancer trajectory, from first presentation. This study successfully brought patient, carer and professional perspectives to the development of a care framework for primary care.

Adult↗
PubMed2005

'Now nobody falls through the net': practitioners' perspectives on the Gold Standards Framework for community palliative care.

The Gold Standards Framework (GSF) seeks to facilitate consistent and high quality community palliative care through a set of guidelines, mechanisms and assessment tools. The present study set out to examine practitioners' perspectives on the GSF during its first national roll-out. Two general practices that had adopted the GSF were recruited in each of four geographical areas, and each matched as closely as possible with a non-GSF practice. Sixty-eight semi-structured telephone interviews were carried out with general practitioners and district nurses in 16 selected practices, along with the GSF facilitator and up to four other 'stakeholders' in each area. Analysis revealed that the majority of GSF participants felt that the framework had strengthened their provision of community palliative care. In particular, communication within primary health care teams and co-ordination of services improved, aspects which were better in the GSF practices than in the matched non-GSF practices. Practitioners felt there was more consistency of care, with a reduced likelihood that individual patients would 'slip through the net'. The most common areas of concern were in relation to the workload associated with the role of the GSF co-ordinator. Implications for the development and effective implementation of the framework and for further research are discussed.

Attitude of Health Personnel↗
PubMed2004

Family carers' experiences of out-of-hours community palliative care: a qualitative study.

Carers' feelings of uncertainty and anxiety can be particularly acute out-of-hours, when they may not have access to familiar sources of professional help and advice. The present study used qualitative semi-structured interviews to explore carers' experiences of out-of-hours care and support services. Fifteen bereaved carers in the Calderdale and Kirklees area were interviewed, and the interview transcripts analysed thematically. In general, carers felt well supported out-of-hours, especially by the nursing services. They appreciated opportunities to develop some degree of personal relationship with those they saw out-of-hours. However, in some cases problems were apparent. These were associated with poor provision of information, inadequate communication with carers, difficulties in accessing night-sitter services, or the inflexibility of services. The findings underline the importance of primary care practitioners taking an anticipatory approach to community palliative care.

After-Hours Care↗
PubMed2003

An out-of-hours protocol for community palliative care: practitioners' perspectives.

Much of palliative care takes place in the patient's home. Out-of-hours service provision can be an area of concern. With the aim of improving this service, the former Calderdale and Kirklees Health Authority introduced an out-of-hours protocol for palliative care in the community. After 1 year the authors examined the experiences of primary care practitioners in using the protocol. Twenty district nurses and 15 GPs from 25 general practices in Calderdale, Huddersfield and North Kirklees took part in the study, which involved face-to-face group and individual telephone interviews. Practitioners felt that the out-of-hours protocol had made a positive contribution to palliative care in the community and that the out-of-hours handover form played a key role in improving communications and the coordination of services. For many participants, the protocol encouraged a more anticipatory approach to care and enabled better access to drugs and to specialist advice. The main areas of concern related to updating patient information on the handover forms, and to shortcomings in the support offered to carers. Future developments should address these issues. Although recognizing the dangers of generalization from research of this type, the findings offer encouragement to others considering similar schemes.

Attitude of Health Personnel↗