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Randomized Controlled Trial
. 2014 Nov;17(11):1244-8.
doi: 10.1089/jpm.2014.0146.

Clinician roles in early integrated palliative care for patients with advanced cancer: a qualitative study

Anthony L Back  1 , Elyse R Park, Joseph A Greer, Vicki A Jackson, Juliet C Jacobsen, Emily R Gallagher, Jennifer S Temel
Affiliations
Randomized Controlled Trial

Clinician roles in early integrated palliative care for patients with advanced cancer: a qualitative study

Anthony L Back et al. J Palliat Med. 2014 Nov.

Abstract

Background: Early palliative care provides better quality of life, increased prognostic awareness, and even improved survival for patients with advanced cancer but how the integrated care model achieves these outcomes has not been completely explained.

Methods: To better understand the clinical approach to early outpatient care from the clinicians' perspective, we conducted focus groups with the palliative care clinicians who had participated in a randomized trial of early palliative care for metastatic lung cancer.

Results: Clinicians described their role in providing early palliative care as having three distinct roles in the outpatient setting: (1) managing symptoms to improve functional status and as a bridge to other issues; (2) engaging patients in emotional work to facilitate coping, accepting, and planning; and (3) interpreting the oncologist for the patient and the patient for the oncologist.

Conclusions: These data lay the foundation for developing training programs for clinicians in early integrated palliative care.

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References

    1. Temel JS, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ: Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010;363:733–42 - PubMed
    1. Temel JS, Gallagher ER, Jackson VA, Lynch TJ, Lennes IT, Dahlin CM, Pirl WF: Longitudinal perceptions of prognosis and goals of therapy in patients with metastatic non-small-cell lung cancer: Results of a randomized study of early palliative care. J Clin Oncol 2011;29:2319–2326 - PubMed
    1. Von Roenn JH, Temel J: The integration of palliative care and oncology: The evidence. Oncology (Williston Park) 2011;25:1258–1260, 1262, 1264–1265 - PubMed
    1. Greer JA, Jackson VA, Meier DE, Temel JS: Early integration of palliative care services with standard oncology care for patients with advanced cancer. CA Cancer J Clin 2013;63:349–363 - PubMed
    1. Yoong J, Park ER, Greer JA, Jackson VA, Gallagher ER, Pirl WF, Back AL, Temel JS: Early palliative care in advanced lung cancer: A qualitative study. JAMA Intern Med 2013;173:283–290 - PubMed

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