Exploring Perceptions of Palliative Care Among Rural Dwelling Veterans

Abstract

Aim.  To explore the palliative care perceptions of rural dwelling veterans in a completely rural area of the United States.

Background.  As a whole, rural dwelling people have reduced access to health care, including palliative care.  Palliative care can effectively address the distressing physical, emotional, psychological and spiritual suffering related to either serious acute or chronic conditions; additionally, it can be delivered at the same time with usual treatment at any point in the disease trajectory to improve the quality of life for rural dwelling veterans living with serious chronic conditions. However, a significant gap exists in the research pertaining to the perceptions of palliative care among rural dwelling veterans. 

Method.  A qualitative study using a descriptive phenomenological approach was conducted as part of a larger mixed methods study. The setting was a geographically defined rural area encompassing over 8,500 square miles. Rural nursing theory served as the conceptual lens for this study. Audio-recorded, semi-structured, face-to-face interviews were conducted with a purposive sample of six male rural dwelling veterans using an interview guide. Subsequently, data were analyzed using a thematic analysis process.

Findings.  Four themes were identified: uncertainty about palliative care; where and when; palliative care is not hospice care; and opportunities. Rural veterans were found to be unaware of the meaning of palliative care. Five of the six veterans did not perceive palliative care to be end-of-life. A unique finding, none of the rural dwelling veterans perceived palliative care to be hospice care.

Conclusions.  In this study, rural veterans perceived hospice care and palliative care to be different.  Veterans in this sample were unable to define palliative care and did not associate it with an improved quality of life. Therefore, broad-based palliative care education is needed for rural dwelling veterans and for healthcare professionals providing their care.

Keywords:  rural veterans, palliative care, aging in place, rural nursing theory, hospice

DOI:  http://dx.doi.org/10.14574/ojrnhc.v19i1.528