Perspectives of Canadian health leaders on the relationship between medical assistance in dying and palliative and end-of-life care services : a qualitative study
© 2024 CMA Impact Inc. or its licensors..
BACKGROUND: Medical assistance in dying (MAiD) was legalized in Canada in 2016, but coordination of MAiD and palliative and end-of-life care (PEOLC) services remains underdeveloped. We sought to understand the perspectives of health leaders across Canada on the relationship between MAiD and PEOLC services and to identify opportunities for improved coordination.
METHODS: In this quantitative study, we purposively sampled health leaders across Canada with expertise in MAiD, PEOLC, or both. We conducted semi-structured interviews between April 2021 and January 2022. Interview transcripts were coded independently by 2 researchers and reconciled to identify key themes using content analysis. We applied the PATH framework for Integrated Health Services to guide data collection and analysis.
RESULTS: We conducted 36 interviews. Participants expressed diverse views about the optimal relationship between MAiD and PEOLC, and the desirability of integration, separation, or coordination of these services. We identified 11 themes to improve the relationship between the services across 4 PATH levels: client-centred services (e.g., educate public); health operations (e.g., cultivate compassionate and proactive leadership); health systems (e.g., conduct broad and inclusive consultation and planning); and intersectoral initiatives (e.g., provide standard practice guidelines across health care systems).
INTERPRETATION: Health leaders recognized that cooperation between MAiD and PEOLC services is required for appropriate referrals, care coordination, and patient care. They identified the need for public and provider education, standardized practice guidelines, relationship-building, and leadership. Our findings have implications for MAiD and PEOLC policy development and clinical practice in Canada and other jurisdictions.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:196 |
|---|---|
| Enthalten in: |
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne - 196(2024), 7 vom: 25. Feb., Seite E222-E234 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Shapiro, Gilla K [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 28.02.2024 Date Revised 29.02.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1503/cmaj.231241 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM368987477 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM368987477 | ||
| 003 | DE-627 | ||
| 005 | 20240229235221.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240229s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1503/cmaj.231241 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1311.xml |
| 035 | |a (DE-627)NLM368987477 | ||
| 035 | |a (NLM)38408784 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Shapiro, Gilla K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Perspectives of Canadian health leaders on the relationship between medical assistance in dying and palliative and end-of-life care services |b a qualitative study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 28.02.2024 | ||
| 500 | |a Date Revised 29.02.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 CMA Impact Inc. or its licensors. | ||
| 520 | |a BACKGROUND: Medical assistance in dying (MAiD) was legalized in Canada in 2016, but coordination of MAiD and palliative and end-of-life care (PEOLC) services remains underdeveloped. We sought to understand the perspectives of health leaders across Canada on the relationship between MAiD and PEOLC services and to identify opportunities for improved coordination | ||
| 520 | |a METHODS: In this quantitative study, we purposively sampled health leaders across Canada with expertise in MAiD, PEOLC, or both. We conducted semi-structured interviews between April 2021 and January 2022. Interview transcripts were coded independently by 2 researchers and reconciled to identify key themes using content analysis. We applied the PATH framework for Integrated Health Services to guide data collection and analysis | ||
| 520 | |a RESULTS: We conducted 36 interviews. Participants expressed diverse views about the optimal relationship between MAiD and PEOLC, and the desirability of integration, separation, or coordination of these services. We identified 11 themes to improve the relationship between the services across 4 PATH levels: client-centred services (e.g., educate public); health operations (e.g., cultivate compassionate and proactive leadership); health systems (e.g., conduct broad and inclusive consultation and planning); and intersectoral initiatives (e.g., provide standard practice guidelines across health care systems) | ||
| 520 | |a INTERPRETATION: Health leaders recognized that cooperation between MAiD and PEOLC services is required for appropriate referrals, care coordination, and patient care. They identified the need for public and provider education, standardized practice guidelines, relationship-building, and leadership. Our findings have implications for MAiD and PEOLC policy development and clinical practice in Canada and other jurisdictions | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Tong, Eryn |e verfasserin |4 aut | |
| 700 | 1 | |a Nissim, Rinat |e verfasserin |4 aut | |
| 700 | 1 | |a Zimmermann, Camilla |e verfasserin |4 aut | |
| 700 | 1 | |a Allin, Sara |e verfasserin |4 aut | |
| 700 | 1 | |a Gibson, Jennifer L |e verfasserin |4 aut | |
| 700 | 1 | |a Lau, Sharlane C L |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Madeline |e verfasserin |4 aut | |
| 700 | 1 | |a Rodin, Gary |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne |d 1985 |g 196(2024), 7 vom: 25. Feb., Seite E222-E234 |w (DE-627)NLM012612766 |x 1488-2329 |7 nnns |
| 773 | 1 | 8 | |g volume:196 |g year:2024 |g number:7 |g day:25 |g month:02 |g pages:E222-E234 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1503/cmaj.231241 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 196 |j 2024 |e 7 |b 25 |c 02 |h E222-E234 | ||