Mai E Khalaf, Hassan Ziada, Neamat Hassan Abubakr
The Dental Educational Environment of Online and Blended Learning during COVID-19, and the Impact on the Future of Dental Education
Dentistry journal
one measure quality palliative care involves ensuring people approaching end life able receive care ultimately die places choose canadian palliative care policy directives stem tenet autonomy acknowledging people prefer die home feel safe comfortable limited research however considers lack choice people positioned structurally vulnerable eg experiencing extreme poverty homelessness substanceusecriminalization etc regard places care death option dyinginplace often denied drawing ethnographic participatory action research data collected two studies took place 2014 2019 urban centre british columbia canada analysis explores barriers preventing people experience social structural inequity option dieinplace participants include 1 people positioned structurally vulnerable palliative trajectory 2 informal support personsfamily caregivers eg street family 3 community service providers eg housing workers medical professionals 4 key informants eg managers medical directors executive directors data includes observational fieldnotes focus group interviews transcripts interpretive thematic analytic techniques employed participants palliative trajectory lacked access stable affordable permanent housing yet expressed desire stay inplace end life analysis reveals three main barriers impeding choice remain inplace end life 1 misaligned perceptions risk safety 2 challenges managing pain context substance use stigma discrimination 3 gaps protocols policies procedures health teams findings demonstrate rhetoric choice regard preferred place death ethically problematic experienced inequities produced constrained sociostructural forces reach beyond individuals control ultimately findings contribute suggestions policy programs practice enhance inclusiveness palliative care redefining home within palliative care enhancing supports education training community care workers integrating palliative approaches care everyday work nonhealth care providers acknowledging valuing building upon existing relations care help overcome existing barriers delivering palliative care various settings increase opportunity spend end life places prefer