With the increased attention and demand on community-based palliative and end-of-life (EOL) care services comes the question of how to ensure their sustainability. Sustainability has three key attributes: acceptability, affordability and adaptability. Having established the acceptability and affordability of the community-based service, this paper focussed on adaptability, as the remaining issue affecting long-term sustainability. The aim of this study was to identify components of the palliative and EOL service which require adaptability to ensure long-term sustainability for the service. A mixed methods approach was used for this study. Semi-structured interviews were conducted with family members. Semi-structured focus groups and interviews were held with health professionals. Patient data were included to describe frequency and nature of contacts. The results were analysed using descriptive analysis. The setting was a rural town in Victoria, Australia. Nine family members were interviewed, and 16 health professionals were interviewed or took part in a focus group. Patient data included 121 participants. Four themes were identified: the uniqueness of the patient, workforce issues, collaboration between services and symptom and pain management. All themes indicated that the palliative and EOL service faces challenges which may threaten the sustainability of the service and require adaptability. Families regard palliative and EOL care as special and valued, and appreciate the endeavour, care and support taken to assist their loved one to die with dignity regardless of the location and setting. With sufficient attention paid to the adaptability of the service, community palliative and EOL care service can become more sustainable, thus offering choice and dignity for people approaching the end of life.

中文翻译：

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使社区姑息治疗和临终关怀具有可持续性；调查澳大利亚农村服务提供的适应性

随着对基于社区的姑息治疗和临终关怀 (EOL) 护理服务的关注和需求增加，出现了如何确保其可持续性的问题。可持续性具有三个关键属性：可接受性、可负担性和适应性。在确定了基于社区的服务的可接受性和可负担性之后，本文重点关注适应性，作为影响长期可持续性的遗留问题。本研究的目的是确定需要适应性以确保服务的长期可持续性的姑息治疗和 EOL 服务的组成部分。本研究采用混合方法。对家庭成员进行了半结构化访谈。与卫生专业人员进行了半结构化的焦点小组和访谈。包括患者数据以描述接触的频率和性质。使用描述性分析对结果进行分析。背景是澳大利亚维多利亚的一个乡村小镇。9 名家庭成员接受了采访，16 名卫生专业人员接受了采访或参加了焦点小组。患者数据包括 121 名参与者。确定了四个主题：患者的独特性、劳动力问题、服务与症状和疼痛管理之间的协作。所有主题都表明姑息治疗和 EOL 服务面临挑战，可能威胁服务的可持续性并需要适应性。家庭将姑息治疗和 EOL 护理视为特殊和宝贵的东西，并感谢他们为帮助亲人有尊严地死去而做出的努力、关怀和支持，而无论地点和环境如何。