Evidence map›Paper›PMID 30208872›Full record

ArticleBMC health services research2018

Perceived barriers and facilitators in providing palliative care for people with severe dementia: the healthcare professionals' experiences.

May Helen Midtbust, Rigmor Einang Alnes, Eva Gjengedal, Else Lykkeslet

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In one paragraph

Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  7. Care Provider Perceptions of Person-Centeredness in Geriatric Care.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

May Helen MidtbustFaculty of Medicine and Health Sciences, Department for Health Sciences in Aalesund, Norwegian University of Science and Technology, Box 1517, NO 6025, Aalesund, Norway. mmi@ntnu.no.ORCID http://orcid.org/0000-0002-7007-6663
Rigmor Einang AlnesFaculty of Medicine and Health Sciences, Department for Health Sciences in Aalesund, Norwegian University of Science and Technology, Box 1517, NO 6025, Aalesund, Norway.
Eva GjengedalUniversity of Bergen, Global Public Health and Primary Care, Box 7804, 5020, Bergen, Norway.
Else LykkesletFaculty of Health Sciences and Social Care, Molde University College, Box 2110, NO 6402, Molde, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDementia has become a major public health issue worldwide due to its rapidly increasing prevalence and an increasing number of dementia-related deaths in long-term care facilities. The aim of this study was to examine health professionals' experiences of potential barriers and facilitators in providing palliative care for people with severe dementia in long-term care facilities.

methodsThis was a qualitative descriptive study. The data were collected from four focus groups and 20 individual in-depth interviews with healthcare professionals from four Norwegian nursing homes. The data were analysed by thematic text analysis, as described by Braun and Clarke.

resultsThe major findings indicate that healthcare professionals experience a lack of continuity as the main barrier to facilitating palliative care. Time pressure and increased efficiency requirements especially affect the weakest and bedridden residents with dementia. The healthcare professionals feel conflicted between wanting to spend more time caring for each individual resident and feeling pressure to help everyone. Although resources are scarce, dying residents are always given priority by healthcare professionals, either by the hiring of extra personnel or the reorganization of tasks in a way that facilitates someone staying with the terminal resident. Advanced care planning was highlighted as a facilitator in providing palliative care, but the extensive use of temporary staff among nurses and doctors and the relocation between the sheltered and long-term wards threaten the continuity in planning and providing palliative care.

conclusionsThe findings indicate that healthcare professionals experienced several structural barriers that prevented the provision of palliative care to people with severe dementia in long-term care facilities. Increasing demands for economic rationality lead to a lack of continuity of care. Organizational changes, such as measures to increase the competence and the proportion of permanent employees and the prevention of burdensome end-of-life transitions, should be implemented to improve continuity and quality of care.

Indexed as

Attitude of Health PersonnelHealth PersonnelAgedContinuity of Patient CareDementiaFocus GroupsHealth ResourcesHealth Services AccessibilityHumansNorwayNursing HomesPalliative CareQualitative ResearchBarriersDementiaFacilitatorsFocus groupsLong-term care facilitiesPalliative careQualitative approaches

Identifiers

PMID30208872
PMCPMC6134769

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.