Barriers to palliative care use among surgical patients: perspectives of practicing surgeons across Michigan.
Ann Palliat Med
; 10(2): 1122-1132, 2021 Feb.
Article
de En
| MEDLINE
| ID: mdl-32921121
ABSTRACT
BACKGROUND:
Despite the clear benefits of palliative care, surgical patients are less likely to receive palliative care consultations when compared to their medical counterparts. In this context, we conducted semi-structured interviews with a diverse range of practicing surgeons to better understand surgeon attitudes and experiences with both palliative care approaches and specialty services.METHODS:
Forty-six surgeons from community, tertiary-care, and academic institutions across the state of Michigan agreed to participate in this study. Each participant's interview lasted between 30 and 60 minutes and was digitally recorded. Audiotapes were transcribed verbatim and de-identified for names and places. The data were analyzed through iterative steps informed by thematic analysis.RESULTS:
Six major themes emerged describing surgeon-reported barriers to palliative care approaches and use of palliative care services, which were observed at the surgeon-level, patient and family-level, and system-level. At the surgeon-level, the following three major themes emerged surgeon knowledge and attitudes, prognostication challenges, and surgeon identity. At the patient and family-level, two major themes were identified expectations and discordance. At the system-level, two major themes emerged culture and resources.CONCLUSIONS:
Among our cohort of surgeons, several key factors influenced their use of palliative approaches and specialty palliative care services. A better understanding of surgeon-perceived barriers may lead to future work aimed at creating meaningful, surgeon-specific interventions that address the underuse of this important care for surgical patients and patients being considered for surgery.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Soins infirmiers en centre de soins palliatifs
/
Chirurgiens
Type d'étude:
Prognostic_studies
/
Qualitative_research
Limites:
Humans
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Ann Palliat Med
Année:
2021
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique