PT  - JOURNAL ARTICLE
AU  - Thijs Reyniers
AU  - Dirk Houttekier
AU  - H. Roeline Pasman
AU  - Robert Vander Stichele
AU  - Joachim Cohen
AU  - Luc Deliens
TI  - The Family Physician’s Perceived Role in Preventing and Guiding Hospital Admissions at the End of Life: A Focus Group Study
AID  - 10.1370/afm.1666
DP  - 2014 Sep 01
TA  - The Annals of Family Medicine
PG  - 441--446
VI  - 12
IP  - 5
4099  - http://www.annfammed.org/content/12/5/441.short
4100  - http://www.annfammed.org/content/12/5/441.full
SO  - Ann Fam Med2014 Sep 01; 12
AB  - PURPOSE Family physicians play a pivotal role in providing end-of-life care and in enabling terminally ill patients to die in familiar surroundings. The purpose of this study was to explore the family physicians’ perceptions of their role and the difficulties they have in preventing and guiding hospital admissions at the end of life. METHODS Five focus groups were held with family physicians (N= 39) in Belgium. Discussions were transcribed verbatim and analyzed using a constant comparative approach. RESULTS Five key roles in preventing and guiding hospital admissions at the end of life were identified: as a care planner, anticipating future scenarios; as an initiator of decisions in acute situations, mostly in an advisory manner; as a provider of end-of-life care, in which competency and attitude is considered important; as a provider of support, particularly by being available during acute situations; and as a decision maker, taking overall responsibility. CONCLUSIONS Family physicians face many different and complex roles and difficulties in preventing and guiding hospital admissions at the end of life. Enhancing the family physician’s role as a gatekeeper to hospital services, offering the physicians more end-of-life care training, and developing or expanding initiatives to support them could contribute to a lower proportion of hospital admissions at the end of life.