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Haematologists’ perceptions of palliative care and specialist palliative care referral: a qualitative study
  1. Bethany Wright1 and
  2. Karen Forbes2
  1. 1St Peter's Hospice, Bristol, UK
  2. 2University of Bristol and University Hospitals Bristol NHS Trust, Bristol, UK
  1. Correspondence to Dr Bethany Wright, St Peter's Hospice, Charlton Road, Brentry, Bristol BS10 6NL, UK; bethanywright{at}doctors.org.uk

Abstract

Objectives This study explored the views and perceptions of haematologists towards palliative care, based on their own clinical experiences, focusing on those factors that helped or hindered referral to specialist palliative care (SPC) services.

Method We conducted in-depth face-to-face interviews with a purposive sample of eight trainee and consultant haematologists working in tertiary referral centres in the West Midlands. All interviews were recorded, transcribed and subsequently analysed using the principles of the grounded theory approach.

Results Data analysis revealed a core category around boundaries alongside four emerging categories: perceptions of palliative care; philosophy of approach; determining roles; and responsibility and control. Positive attitudes towards SPC involvement were expressed by most participants. The role of SPC services was sometimes difficult for participants to define, with timing of referral often determined by their level of confidence in providing end-of-life care. Almost all highlighted a lack of inpatient palliative care unit provision; this was viewed negatively and impacted on referral.

Conclusions While positive attitudes towards palliative care were expressed, barriers to collaboration between haematology and SPC services were identified and provided opportunities for improved interdisciplinary working. Suggestions for improvement are focused around: improved training; enhanced mutual respect and understanding; clearer definition of the role of SPC services; and consistency and flexibility in service provision.

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  • Received 24 March 2014.
  • Revision received 1 August 2014.
  • Accepted 9 September 2014.
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Footnotes

  • Contributors BW conceived the study and was responsible for data collection. BW and KF were responsible for data analysis and contributed towards writing of the manuscript. BW and KF are guarantors.

  • Competing interests None.

  • Ethics approval The study was conducted with ethical approval from Coventry Local Research Ethics Committee (reference 09/H1210/81).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Unpublished data would be available by emailing the corresponding author.

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