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end-of-life care, integrated services network, modes of participation, palliative care, qualitative case study



  1. Morin, Diane PhD, RN
  2. Saint-Laurent, Louise PhD, Soc
  3. Bresse, Marie-Pier Soc, BA
  4. Fillion, Lise PhD, RN, Psy
  5. Dallaire, Clemence PhD, RN


This article presents modes of participation associated with a successful territorial implementation of a palliative care integrated services network as perceived by the diverse groups of stakeholders involved. A qualitative case study was performed in Quebec, Canada, using individual (n = 16) and group (n = 16) interviews, with a total of 106 participants. The analyses were based on the frameworks of Giddens and Patton. From a content analysis, a typology of six interconnected modes of participation at different levels of action emerged: territorial partnership, intraorganizational and interorganizational cooperation, interprofessional collaboration, community contribution, family commitment, and patient involvement. The interplay of the actors involved in different contexts was perceived by the participants as essential to improve accessibility, continuity, and quality of palliative care and the successful implementation of an integrated services network. The role of nonprofessionals is rarely taken into account in the functioning of healthcare systems.