RT Journal Article
SR Electronic
T1 Palliative care from the perspective of cancer physicians: a qualitative semistructured interviews study
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP bmjspcare-2020-002455
DO 10.1136/bmjspcare-2020-002455
A1 Guillaume Economos
A1 Alice Bonneville-Levard
A1 Ines Djebari
A1 Kevin Van Thuynes
A1 Colombe Tricou
A1 Élise Perceau-Chambard
A1 Marilene Filbet
YR 2020
UL http://spcare.bmj.com/content/early/2020/09/21/bmjspcare-2020-002455.abstract
AB Objective Integrated palliative care for populations with cancer is now highly recommended. However, numerous physicians working in cancer care are still reluctant to refer patients to specialist palliative care teams. This study explores their perceptions of palliative care and factors influencing reasons to refer to specialist palliative care.Methods We used a qualitative methodology based on semistructured interviews with physicians working in cancer care, in two tertiary hospitals and one comprehensive cancer centre with access to a specialist palliative care team. Forty-six physicians were invited and 18 interviews were performed until data saturation. Participants were mainly men, licensed in cancer care, 37.9 years old on average and had 13 years of professional experience. The length of interviews was on average 34 min (SD=3). Analysis was performed accordingly with the thematic analysis.Results The data analysis found four themes: symptom management as a trigger, psychosocial support, mediation provided by interventions, and the association with terminal care or death. Palliative care integrated interventions were mainly perceived as holistic approaches that offered symptom management expertise and time. They were valued for helping in consolidating decision-making from a different or external perspective, or an ‘outside look’. Several barriers were identified, often due to the confusion between terminal care and palliative care. This was further highlighted by the avoidance of the words ‘palliative care’, which were associated with death.Conclusions National policies for promoting palliative care seemed to have failed in switching oncologists' perception of palliative care, which they still consider as terminal care.