Involvement of general practitioners in palliative cancer care: a qualitative study
- 661 Downloads
General practitioners play an important role in palliative care for cancer patients. The intensity of care and its medical complexity make palliative care a demanding task for general practitioners. This study explored general practitioners' perceptions of their involvement in palliative cancer care and the constraints they confront.
We conducted semi-structured interviews with 13 German general practitioners. Recruitment occurred by means of purposeful sampling to secure maximum heterogeneity. The interviews were electronically recorded, transcribed, and then analyzed using qualitative content analysis according to Mayring.
A number of themes were identified. General practitioners describe being intensely involved in the final phase of their patients' lives. When providing home-based end-of-life care to cancer patients, general practitioners become aware of the limitations in their medical skills and knowledge and their ability to provide round-the-clock care. They find it helpful and satisfying to collaborate with trusted care providers and seek to cooperate with specialized palliative care services for outpatients.
The substantial involvement of general practitioners in end-of-life care for cancer patients pushes them to their limits because of the major time commitment required, and the need for special skills for which they have received no training. It will be a challenge to provide general practitioners with the structural and personal support they need to provide home-based palliative care for their cancer patients at end of life.
KeywordsGeneral practitioner Primary care Palliative care Qualitative Family practice Cancer care
The authors would like to acknowledge the contribution of Erika Kojima who conducted two GP interviews. We would like to thank Phillip Elliott who translated the citations and provided helpful comments on the manuscript, and last but not least, we are very grateful to all the GPs who voluntarily participated in our study.
We would also like to thank the German Cancer Aid for funding the study.
Integrity of research and reporting
After consulting the institutional review board of the University Hospital Frankfurt/Main, ethical approval was not required. The study was conducted in accordance with the ethical standards laid out in the 1964 Declaration of Helsinki.
Conflict of interest
The authors do not have a financial relationship with the organization that sponsored the research. They have full control of all primary data and agree to allow the journal to review their data if requested.
- 7.Van den Block L, Deschepper R, Bossuyt N, Drieskens K, Bauwens S, Van Casteren V, Deliens L (2008) Care for patients in the last months of life: the Belgian Sentinel Network Monitoring End-of-Life Care study. Arch Intern Med 168(16):1747–1754. doi: 10.1001/archinte.168.16.1747 CrossRefPubMedGoogle Scholar
- 8.Schindler T (2006) Palliative care in Germany [German]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 49(11):1077–1086. doi: 10.1007/s00103-006-0068-7
- 17.Mayring P (2000) Qualitative content analysis. Forum: Qual Social Res 1(2):20Google Scholar
- 18.Federal Institute for Research on Building, Urban Affairs and Spatial Development. Continuous city observation – District classifications. Types of cities and communities in Germany [German] http://www.bbsr.bund.de/BBSR/DE/Raumbeobachtung/Raumabgrenzungen/StadtGemeindetyp/StadtGemeindetyp_node.html. Accessed 20 July 2013
- 30.Hannes K (2011) Chapter 4: Critical appraisal of qualitative research. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, Lockwood C (ed) Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions. Version 1 (Updated August 2011). Cochrane Collaboration Qualitative Research Methods Group, http://cqrmg.cochrane.org/supplemental-handbook-guidance. Accessed 20 July 2013