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      A reassuring presence: An evaluation of Bradford District Hospice at Home service

      research-article
      1 , , 2 , 3 , 4
      BMC Palliative Care
      BioMed Central

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          Abstract

          Background

          Within the United Kingdom, a developing role for primary care services in cancer and palliative care has resulted in an increase in palliative home care teams. The provision of professional care in the home setting seeks to provide necessary services and enhanced choice for patients whose preference is to die at home.

          A mismatch between patient preference for home death and the actual number of people who died at home was identified within Bradford, the locality of this study. In response to this mismatch, and reflecting the policy environment of wishing to enhance community service provision, the four Primary Care Trusts (PCTs) in the city sought to offer support to patients who wished to remain in their own homes through the final stages of a terminal illness. To offer this support they set up a dedicated hospice at home team. This would provide services and support for patients in achieving a dignified, symptom free and peaceful death, allowing families to maximise time spent together. The aim of the study was to evaluate the Bradford hospice at home service from the perspective of carers, nurses and General Practitioners.

          Methods

          Postal questionnaires were sent to carers (n = 289), district nurses (n = 508) and GP's (n = 444) using Bradford's hospice at home service. Resulting quantitative data was analysed using the Statical Package for Social Sciences (SPSS) and qualitative data was analysed using grounded theory techniques.

          Results

          The data from carers, district nurses and GPs provide general support for the Bradford hospice at home service. Carers valued highly the opportunity to 'fulfil a promise' to the individual who wished to be cared for at home. District nurses and GPs cited the positive impact of access to specialist expertise. This was a 'reassuring presence' for primary healthcare teams and offered 'relief of carer anxiety' by providing prompt, accessible and sensitive care.

          Conclusion

          Carers and health professionals welcomed the increased possibility of patients being cared for at home. The study identified the need to focus on improving skill levels of staff and on ensuring continuity of care.

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          Most cited references34

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          The Discovery of Grounded Theory

          <p>Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications.</p><p>In Part I of the book, Generation Theory by Comparative Analysis, the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data, the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, Implications of Grounded Theory, Glaser and Strauss examine the credibility of grounded theory.</p><p>The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.</p></p>
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            Basics of Qualitative Research : Techniques and Procedures for Developing Grounded Theory

            The Second Edition of this best-selling textbook continues to offer immensely practical advice and technical expertise that will aid researchers in analyzing and interpreting their collected data, and ultimately build theory from it. The authors provide a step-by-step guide to the research act. Full of definitions and illustrative examples, the book presents criteria for evaluating a study as well as responses to common questions posed by students of qualitative research.
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              Theoritical sensitivity

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                Author and article information

                Journal
                BMC Palliat Care
                BMC Palliative Care
                BioMed Central
                1472-684X
                2008
                1 August 2008
                : 7
                : 9
                Affiliations
                [1 ]Senior Lecturer Pharmacy Education, School of Life Sciences, University of Bradford, Richmond Road, Bradford, BD7 1DP, UK
                [2 ]Professor of Health Research, School of Health Studies, University of Bradford, 25 Trinity Road, Bradford, BD5 0BB, UK
                [3 ]Lecturer, School of Health Studies, University of Bradford, 25 Trinity Road, Bradford, BD5 0BB, UK
                [4 ]Consultant in Palliative Medicine at Bradford Marie Curie Hospice and Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
                Article
                1472-684X-7-9
                10.1186/1472-684X-7-9
                2533294
                18673558
                5bc69128-f9ef-4f19-87c2-ce3d55da8a48
                Copyright © 2008 Lucas et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 October 2007
                : 1 August 2008
                Categories
                Research Article

                Anesthesiology & Pain management
                Anesthesiology & Pain management

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