District nurse advocacy for choice to live and die at home in rural Australia: A scoping study

Background:Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care.O...

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Bibliographic Details
Authors: Reed, Frances M (Author) ; Fitzgerald, Les (Author) ; Bish, Melanie R (Author)
Format: Electronic Article
Language:English
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Published: Sage 2015
In: Nursing ethics
Year: 2015, Volume: 22, Issue: 4, Pages: 479-492
Further subjects:B End-of-life
B Advocacy
B palliative
B district nursing
B Holistic
B Community
Online Access: Volltext (lizenzpflichtig)

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520 |a Background:Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care.Objectives:The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and die at home?, and identify gaps in the knowledge.Method:Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings.Results:34 international studies revealed themes of ‘the nursing relationship’, ‘environment’, ‘communication’, ‘support’ and ‘the holistic client centred district nursing role.Discussion:Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas.Conclusion:It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered. 
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