Australian palliative care providers’ perceptions and experiences of the barriers and facilitators to palliative care provision
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People with advanced cancer who may benefit from specialised palliative care (SPC) do not necessarily access such services.
To obtain a deeper understanding of issues affecting access to SPC, five focus groups were undertaken with nurses (35), physicians (three), allied health professionals (seven) and an academic involved in providing care.
Thematic analysis revealed that palliative care providers consistently view palliative care as a broad holistic approach to care benchmarked on good symptom management. Whilst participants themselves perceived SPC as aiming to maximise the quality of life of the patient and family across all domains of care, they perceived that some health professionals and community members viewed palliative care largely as symptom control and terminal care for access after all disease-modifying treatment has been exhausted. Concern was expressed that such misconceptions were an important barrier to timely SPC. Participants did not nominate a time or particular milestone in the disease process which should prompt referral and suggested that SPC be available at any time where needs are complex and/or are not being met.
Failure to properly recognise and understand the breadth of care provided within the palliative care framework may result in people with advanced cancer and their caregivers not accessing SPC services or accessing them too late to receive maximum benefit. Education may be required to promote the holistic nature of SPC services amongst health professionals and the community and to help realise the potential benefits to patients, families and health professionals resulting from timely access to SPC services.
KeywordsPalliative care Neoplasms Health services accessibility Referral and consultation
This project was undertaken by the Cancer Council New South Wales’ Centre for Health Research and Psycho-oncology (CHeRP) with funding through a University of Newcastle Project Grant (G0183506) and support from the Hunter Medical Research Institute. The views expressed are not necessarily those of the Cancer Council NSW.
Conflict of interest statement
There are no known conflicts of interest.
- 1.Glare P, Clarke S (2002) The interface of oncology and palliative care in tertiary hospitals: a concept in evolution. Cancer Forum 26(1):6–8Google Scholar
- 2.World Health Organization (2002) National cancer control programmes: policies and managerial guidelines, 2nd edn. World Health Organization, GenevaGoogle Scholar
- 3.Palliative Care Australia (2003) Palliative care service provision in Australia: a planning guide. Palliative Care Australia, Deakin WestGoogle Scholar
- 6.Aoun S (2004) The hardest thing we have ever done: the social impact of caring for terminally ill people in Australia 2004. Palliative Care Australia, Deakin WestGoogle Scholar
- 9.Johnson CE (2006) Palliative care in Australia: perceptions and practices of cancer specialists and general practitioners. Ph.D., University of NewcastleGoogle Scholar
- 14.World Health Organization (2004) In: Davies E, Higginson IJ (eds) Palliative care: the solid facts. World Health Organization, Copenhagen, pp 1–36Google Scholar
- 15.Palliative Care Australia (1999) State of the nation: report of the National Census of palliative care services. Palliative Care Australia, CanberraGoogle Scholar
- 16.Liamputtong P, Ezzy D (2005) Qualitative research methods, 2nd edn. Oxford University Press, MelbourneGoogle Scholar
- 17.Holloway I (1997) Basic concepts for qualitative research. Blackwell Science, OxfordGoogle Scholar
- 23.National Cancer Control Initiative, Clinical Oncology Society of Australia, The Cancer Council Australia (2003) Optimising cancer care in Australia. National Cancer Control Initiative, Melbourne, pp 1–122Google Scholar
- 24.Campbell Research & Consulting (2006) Community attitudes towards palliative care. Australian Government Department of Health and Ageing, North FitzroyGoogle Scholar