Electronic Thesis and Dissertation Repository

Degree

Master of Clinical Science

Program

Family Medicine

Supervisor

Dr. Moira Stewart

2nd Supervisor

Dr. Amardeep Thind

Joint Supervisor

Abstract

Family physicians (FPs) care for the majority of community patients approaching end of life. Variations among FPs in care activities for these patients have potential implications for equitable access to care. This thesis used mixed methods to explore how FPs in southwestern Ontario, Canada care for these patients, and what shapes the variations. In the primary study, using grounded theory based on in-depth interviews, FPs reported differing in the timing, location and purpose of their activities. These variations were shaped by a process of ‘making it fit’, in which FPs weighed the implications of choices in their unique contexts. In the second study, a secondary analysis of family physician survey data, FPs reported differences in their potential availability to provide care to community patients at end of life. Attitude toward FP participation in palliative care at home and remuneration by alternate funding plan were both strongly associated with potential availability.


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