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Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC. Karolinska institutet.
Karolinska institutet, Högskolan Dalarna, Göteborgs universitet.
Ersta Sköndal Bräcke University College, The Institute for Organisational and Worklife Ethics.
Lunds univeristet, Region Skåne.
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2017 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 121, no 11, p. 1194-1201, article id S0168-8510(17)30239-7Article in journal (Refereed) Published
Abstract [en]

In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care.

Place, publisher, year, edition, pages
2017. Vol. 121, no 11, p. 1194-1201, article id S0168-8510(17)30239-7
Keywords [en]
Acute care hospital, Consolidated framework for implementation research, Guidelines, Implementation, Palliative care
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Medical and Health Sciences
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URN: urn:nbn:se:esh:diva-6643DOI: 10.1016/j.healthpol.2017.09.011PubMedID: 28969921OAI: oai:DiVA.org:esh-6643DiVA, id: diva2:1183038
Available from: 2018-02-15 Created: 2018-02-15 Last updated: 2018-02-16Bibliographically approved

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