Medical specialists' motivations for referral to specialist palliative care: a qualitative study.


OBJECTIVES:The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists' motivations and triggers underpinning decision-making around referral to palliative care in order to facilitate improvements in referral practices. METHODS:We completed semistructured, qualitative interviews with 20 referring medical specialists. Medical specialists were recruited from a range of specialties in a major metropolitan area in Australia. Participants were sampled through having referred at least one patient to the specialist palliative care unit during the previous 12 months. Analysis consisted of the framework approach augmented by NVivo 9 data analysis software. Key themes were identified and tested for rigour through inter-rater reliability and constant comparison. RESULTS:The major motivations/triggers identified were: (a) disease-based (eg, pain management and symptom control); (b) pre-emptive/strategic (eg, anticipation of need, preparatory objective); (c) crisis/parallel (eg, physical and psychosocial issues); and (d) team-based (eg, referral as policy/team strategy). CONCLUSIONS:Referral to palliative care is motivated by a range of individual, interpersonal and organisational factors. In order to improve the care and quality of life of patients and family caregivers, further work is needed to develop streamlined practices that are sensitive to physical and psychosocial considerations, and patient/family caregiver desires.


Kirby E,Broom A,Good P,Wootton J,Adams J




Has Abstract


2014-09-01 00:00:00














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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Annemans M,Coomans K,Heylighen A

    更新日期:2020-05-14 00:00:00

  • Does place of death vary by deprivation for patients known to specialist palliative care services?

    abstract:OBJECTIVES:Referral to, and usage of, specialist palliative care (SPC) services are not equitable and social deprivation may be a contributory factor in this. Deprivation may also affect the place of death of patients with cancer. No study, however, has investigated whether inequalities persist following referral to SP...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Macfarlane M,Carduff E

    更新日期:2018-12-01 00:00:00

  • "A monster that lives in our lives": experiences of caregivers of people with motor neuron disease and identifying avenues for support.

    abstract:BACKGROUND:A developing body of evidence has provided valuable insight into the experiences of caregivers of people with motor neuron disease; however, understandings of how best to support caregivers remain limited. AIM:This study sought to understand concepts related to the motor neuron disease caregiver experience ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Anderson NH,Gluyas C,Mathers S,Hudson P,Ugalde A

    更新日期:2019-12-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


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    更新日期:2015-04-01 00:00:00

  • Quality of life after interventions for malignant pleural effusions: a systematic review.

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Sivakumar P,Saigal A,Ahmed L

    更新日期:2020-03-01 00:00:00

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    abstract:BACKGROUND:Non-invasive ventilation (NIV) is beneficial for respiratory failure in motor neurone disease (MND) but some patients may wish to stop the intervention. Guidance from the National Institute for Health and Care Excellence recommends that research is needed on NIV withdrawal. There is little in the literature ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Faull C,Rowe Haynes C,Oliver D

    更新日期:2014-03-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Doug M,Adi Y,Williams J,Paul M,Kelly D,Petchey R,Carter YH

    更新日期:2011-09-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Leonard R,Horsfall D,Rosenberg J,Noonan K

    更新日期:2020-06-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Williams C,Gardiner C

    更新日期:2015-06-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: White N,Oostendorp LJ,Minton O,Yardley S,Stone P

    更新日期:2019-11-20 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,随机对照试验


    authors: Fladvad T,Fayers P,Skorpen F,Kaasa S,Klepstad P

    更新日期:2012-12-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


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    更新日期:2018-12-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


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    更新日期:2020-09-17 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Piil K,Nordentoft S,Larsen A,Jarden M

    更新日期:2019-03-01 00:00:00

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    pub_type: 杂志文章,随机对照试验


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    更新日期:2020-03-01 00:00:00

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    pub_type: 杂志文章,评审


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    更新日期:2011-06-01 00:00:00

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    pub_type: 杂志文章


    authors: Hatano Y,Moroni M,Wilcock A,Quinn S,Csikós Á,Allan SG,Agar M,Clark K,Clayton JM,Currow DC

    更新日期:2016-09-01 00:00:00

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    abstract:CONTEXT:Patients with chronic cancer pain frequently suffer severe exacerbations of pain intensity which are difficult to control adequately via pharmaceutical management. Management of these episodes of breakthrough pain (BTP) presents a challenge both to the physician and the patient, and supplemental 'rescue' doses ...

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    pub_type: 杂志文章,评审


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    更新日期:2011-12-01 00:00:00

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    abstract:BACKGROUND:The role of the Community Matron was introduced in 2005 (DoH 2005a) to case-manage those patients deemed as very high intensity service users to prevent and reduce unscheduled admission to secondary care. Related studies on the effectiveness of managed care indicated the need to manage the demand of high ser...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


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    更新日期:2015-04-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:2020-10-13 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


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    pub_type: 杂志文章


    authors: Messer B,Armstrong A,Doris T,Williams T

    更新日期:2020-03-01 00:00:00

  • Potential triggers for the holistic assessment of people with severe chronic obstructive pulmonary disease: analysis of multiperspective, serial qualitative interviews.

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


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    更新日期:2014-06-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Faull C,Wenzel D

    更新日期:2020-05-21 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Senior H,Grant M,Rhee JJ,Aubin M,McVey P,Johnson C,Monterosso L,Nwachukwu H,Fallon-Ferguson J,Yates P,Williams B,Mitchell G

    更新日期:2019-08-29 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


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    更新日期:2020-10-28 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: McLoughlin K,Rhatigan J,Richardson M,Lloyd R

    更新日期:2015-04-01 00:00:00

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Burbeck R,Low J,Sampson EL,Scott R,Bravery R,Candy B

    更新日期:2015-09-01 00:00:00

  • PA4 The companion volunteer service.

    abstract:BACKGROUND:Recruitment and training of Companion Volunteers has developed out of a Companion Sitter Training Programme begun in 2010. (Scottish Journal of Healthcare Chaplaincy Vol 15. No 1, 2012). This programme was established to support patients emotionally and spiritually. While other services were available to off...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Murphy K

    更新日期:2015-04-01 00:00:00

  • Patient healthcare passports in community specialist palliative care: a mixed methods study.

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    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: White C,Sproule J,Brogan P,Watson M

    更新日期:2018-08-18 00:00:00