• Gunn E Grande, Morag C Farquhar, Stephen Ig Barclay, and Chris J Todd.
• School of Nursing, Midwifery and Health, University of Manchester, Manchester, UK. Gunn.Grande@man.ac.uk
• Br J Gen Pract. 2004 Oct 1;54(507):772-8.

BackgroundInformal carers provide the bulk of palliative home care. They largely rely on general practitioners (GPs) and district nurses to support them in this role, yet little is known about what carers themselves consider important in this support.AimTo identify what informal carers valued in the palliative support provided by GPs and district nurses by using carers' own descriptions of such support.Design Of StudyRetrospective interviews.SettingPrimary care in Cambridgeshire.MethodSemi-structured interviews with bereaved carers of 48 patients with cancer and 12 patients with non-cancer diagnoses. Content analysis of carers' evaluative descriptions of GP and district nurse support.ResultsThe accessibility of the GP and district nurse emerged as the most important aspect of support. Enlistment of help from other agencies was also extensively mentioned, together with provision of equipment. Attitude or approach during interactions, and relationship with the professional were important, particularly regarding GP support, whereas support for the carer, information, and symptom control were mentioned less often. Data suggested that support was not as good for older patients (> or =75 years), but this finding requires further investigation.ConclusionResults largely confirmed findings of previous, quantitative research and the importance of a patient-centred approach. What emerged most strongly, however, was the central importance of accessibility of support services for lay carers responsible for end-of-life home care. This mainly concerned GP and district nurse support, but accessibility of additional care and equipment were also important. In short, carers' main focus was the basic support that enabled them to sustain care in the home.

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