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. 2013 Oct;11(5):415-23.
doi: 10.1017/S1478951512000673. Epub 2012 Oct 8.

Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center

Marie Bakitas  1 , Kathleen Doyle Lyons, Mark T Hegel, Tim Ahles
Affiliations

Oncologists' perspectives on concurrent palliative care in a National Cancer Institute-designated comprehensive cancer center

Marie Bakitas et al. Palliat Support Care. 2013 Oct.

Abstract

Objective: The purpose of this study was to understand oncology clinicians' perspectives about the care of advanced cancer patients following the completion of the ENABLE II (Educate, Nurture, Advise, Before Life Ends) randomized clinical trial (RCT) of a concurrent oncology palliative care model.

Method: This was a qualitative interview study of 35 oncology clinicians about their approach to patients with advanced cancer and the effect of the ENABLE II RCT.

Results: Oncologists believed that integrating palliative care at the time of an advanced cancer diagnosis enhanced patient care and complemented their practice. Self-assessment of their practice with advanced cancer patients comprised four themes: (1) treating the whole patient, (2) focusing on quality versus quantity of life, (3) “some patients just want to fight,” and (4) helping with transitions; timing is everything. Five themes comprised oncologists' views on the complementary role of palliative care: (1) “refer early and often,” (2) referral challenges: “Palliative” equals “hospice”; “Heme patients are different,” (3) palliative care as consultants or co-managers, (4) palliative care “shares the load,” and (5) ENABLE II facilitated palliative care integration.

Significance of results: Oncologists described the RCT as holistic and complementary, and as a significant factor in adopting concurrent care as a standard of care.

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Figures

Figure 1
Figure 1. Oncologists’ Self-assessment and Views on Concurrent Palliative Care for Patients with Advanced Cancer: Themes and Exemplar Quotes
PCS=Palliative Care Service; APRN=Advanced Practice Registered Nurse; Heme=Hematology; ENABLE (Educate, Nurture, Advise, Before Life Ends) Study Intervention
See this image and copyright information in PMC

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