Rural general practitioner perspectives of the needs of Maori patients requiring palliative care.

AIM: We aimed to identify rural general practitioners perspectives of the needs of Maori patients receiving palliative care and to discover what actions the general practitioners had undertaken to meet these needs. METHODS: This was a cross sectional postal survey of rural general practitioners. A questionnaire was developed which included a number of questions relevant to cultural needs when providing palliative care to Maori. RESULTS: 186/440 rural general practitioners responded to the survey. 52% said that they had no Maori with palliative care needs in the last 12 months, 23% had one patient and 25% had looked after 2 or more. An estimated 126/204 (62%) Maori patients had died at home. The greatest need identified by rural general practitioners when dealing with Maori patients requiring palliative care appears to be for good communication which they saw as especially important when a large family/whanau are likely to be involved. Other notable concerns were the apparent gaps in some areas for home care and the demand for more Maori nurses to be available in rural areas. CONCLUSIONS: It appeared that there was great variation in the demand for palliative care services for Maori. Some rural general practitioners rarely encounter Maori patients whilst for others caring for Maori who are in need of palliative care is an important part of their practice. There is some demand from general practice for cultural competency training and support from Maori providers and Maori services in District Health Boards. Further research in this area would be valuable.

Palliative care provision by rural general practitioners in New Zealand.

OBJECTIVES: The aim of this study was to ascertain the workload for rural general practitioners providing palliative care and to identify barriers to care for patients living in rural areas of New Zealand. DESIGN AND METHODS: This was a cross-sectional survey of rural general practitioners using a postal questionnaire. RESULTS: One hundred eighty-six questionnaires were returned. Of respondents, 98% provided palliative care. The estimated mean number of patients cared for in the previous 12 months was 7.3. Specialist medical advice from a hospice or palliative care consultant was accessed by 77% of respondents. District and community nursing was available to over 90% of respondents but this was not universally available 24 hours a day in all areas. Forty-seven percent of rural palliative care patients died at home. CONCLUSIONS: Commitment of general practitioners to palliative care appeared high although the workload was a relatively small part of their activity. There seems to be a need for wider availability of specialist advice, 24-hour nursing cover, and some support services. A commitment to supporting domiciliary services is needed if large increases in institutional care are to be avoided in the future.