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














  • Analysis of health administration data to inform health service planning for paediatric palliative care.

    abstract:BACKGROUND:Health service planning in paediatric palliative care is complex, with the diverse geographical and demographic characteristics adding to the challenge of developing services across different nations. Accurate and reliable data are essential to inform effective, efficient and equitable health services. AIM:...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Bowers AP,Bradford N,Chan RJ,Herbert A,Yates P

    更新日期:2020-10-13 00:00:00

  • Cancer symptom scale preferences: does one size fit all?

    abstract:OBJECTIVES:Patients with advanced cancer do not report all symptoms, so assessment is best done systematically. However, for such patients, completion rates of some symptom instruments are <50%. Symptoms can be quantified by various scales including the Categorical Response Scale (CRS), Numerical Rating Scale (NRS) and...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Jeter K,Blackwell S,Burke L,Joyce D,Moran C,Conway EV,Cremen I,O'Connor B,Ui Dhuibhir P,Walsh D

    更新日期:2018-06-01 00:00:00

  • Resuscitation status conversations: a short education session improves junior doctors' confidence.

    abstract:AIM:Junior doctors are frequently required to discuss resuscitation status with patients. They generally lack experience, confidence and skill in having these conversations. However, there is currently no formal postgraduate education requirement to improve or develop in this area. The aim of this educational intervent...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Ferguson L,Clark H,de Beer W

    更新日期:2020-08-21 00:00:00

  • Methodological considerations for researching the financial costs of family caregiving within a palliative care context.

    abstract:BACKGROUND:The financial impact of family caregiving in a palliative care context has been identified as an issue which requires further research. However, little is known about how research should be conducted in this area. OBJECTIVE:The aim of this study was to explore the opinions of family caregivers in New Zealan...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Gardiner C,Allen R,Moeke-Maxwell T,Robinson J,Gott M

    更新日期:2016-12-01 00:00:00

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

    abstract:BACKGROUND:Malignant pleural effusion (MPE) results in breathlessness and impairment of health-related quality of life (HRQOL). This study reviews the existing literature on HRQOL following invasive interventions in MPE. METHODS:Five electronic databases were systematically searched and assessed three times during the...

    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

  • Purple urine bag syndrome in palliative care.

    abstract::Purple urine bag syndrome (PUBS) is a rare condition characterised by urine discolouration. The management of PUBS remains controversial. Four females (mean age 84.5±9.7 years) with palliative conditions (two cancer and two non-cancer cases) presenting PUBS were identified. Urine bags were changed in all cases. Urinar...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Wattanapisit S,Wattanapisit A,Meepuakmak A,Rakkapan P

    更新日期:2019-06-01 00:00:00

  • Quality versus risk of bias assessment of palliative care trials: comparison of two tools.

    abstract:BACKGROUND:Randomised controlled trials (RCTs) of palliative care interventions are challenging to conduct and evaluate. Tools used to judge the quality of RCTs do not account for the complexities of conducting research in seriously ill populations and may artificially downgrade confidence in palliative care research. ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Isenberg SR,Kavalieratos D,Chow R,Le L,Wegier P,Zimmermann C

    更新日期:2020-11-18 00:00:00

  • Factors affecting recruitment to an observational multicentre palliative care study.

    abstract:OBJECTIVES:To identify those factors which adversely affected recruitment to a large multicentre palliative care study. METHODS:Patient accrual to a multicentre, observational, palliative care study was monitored at three critical junctures in the research process. (1) Eligibility-did the patient fulfil the study entr...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,多中心研究


    authors: Stone PC,Gwilliam B,Keeley V,Todd C,Kelly LC,Barclay S

    更新日期:2013-09-01 00:00:00

  • Systematic mixed-method review of barriers to end-of-life communication in the family context.

    abstract:BACKGROUND:Communication about the end of life is especially important in the family context, as patients and their families are considered as the care unit in palliative care. Open end-of-life communication can positively affect medical, psychological and relational outcomes during the dying process for patient and fa...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


    authors: Nagelschmidt K,Leppin N,Seifart C,Rief W,von Blanckenburg P

    更新日期:2020-08-27 00:00:00

  • Collaborative palliative care for advanced heart failure: outcomes and costs from the 'Better Together' pilot study.

    abstract:BACKGROUND:Patients with heart failure often receive little supportive or palliative care. 'Better Together' was a 2-year pilot study of a palliative care service for patients with advanced congestive heart failure (CHF). OBJECTIVE:To determine if the intervention made it more likely that patients would be cared for a...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Pattenden JF,Mason AR,Lewin RJ

    更新日期:2013-03-01 00:00:00

  • Long-term survival in recurrent adrenocortical cancer.

    abstract::Adrenocortical carcinoma (ACC) comprises approximately 0.02% of all malignant tumours, which are a very small fraction of a group of cancers that affect in 0.7 to 2 in 1 000 000 people per year. Recurrence is very common even after complete resection and prognosis is poor. We report a case of a sporadic form of ACC fo...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Shuayb M,Das A,Uddin MN

    更新日期:2019-03-01 00:00:00

  • Euthanasia and palliative sedation in Belgium.

    abstract::The aim of this article is to use data from Belgium to analyse distinctions between palliative sedation and euthanasia. There is a need to reduce confusion and improve communication related to patient management at the end of life specifically regarding the rapidly expanding area of patient care that incorporates a sp...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Cohen-Almagor R,Ely EW

    更新日期:2018-09-01 00:00:00

  • Palliative care in Africa since 2005: good progress, but much further to go.

    abstract::There has been rapid progress in palliative care in Africa since the World Health Assembly in 2005 which identified palliative care as an urgent humanitarian need. Palliative care is now recognised as a basic human right, and momentum has gathered to translate this into action. From being significantly present in only...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


    authors: Grant L,Downing J,Namukwaya E,Leng M,Murray SA

    更新日期:2011-09-01 00:00:00

  • Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study.

    abstract:BACKGROUND:Undergraduate teaching currently fails to adequately prepare doctors to deliver 'end-of-life' care. Despite much evidence supporting simulation-based teaching, its use in medical undergraduate palliative and 'end-of-life' care curricula remain low. AIM:This study assesses whether simulation can improve the ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Wells G,Montgomery J,Hiersche A

    更新日期:2019-08-28 00:00:00

  • Is palliative care cost-effective in low-income and middle-income countries? A mixed-methods systematic review.

    abstract:INTRODUCTION:Of the 40 million people globally in need of palliative care (PC), just 14% receive it, predominantly in high-income countries. Within fragile health systems that lack PC, incurable illness is often marked by pain and suffering, as well as burdensome costs. In high-income settings, PC decreases healthcare ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Reid EA,Kovalerchik O,Jubanyik K,Brown S,Hersey D,Grant L

    更新日期:2019-06-01 00:00:00

  • Enzyme replacement in advanced pancreatic cancer: patient perceptions.

    abstract:PURPOSE:Advanced pancreatic cancer has a universally poor survival rate. Patients frequently develop malabsorption that requires pancreatic enzyme replacement therapy (PERT). This study explores the experience of patient engagement with PERT and how the medication is taken and tolerated. METHODS:Participants with adva...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Landers A,McKenzie C,Pitama SG,Brown H

    更新日期:2020-03-22 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

  • Assisted ventilation in motor neurone disease during inpatient palliative care: barriers and utilisation.

    abstract:OBJECTIVES:An increasing number of patients with motor neuron disease (MND) in the UK and Ireland use assisted ventilation, and a small proportion of these use long-term tracheostomy ventilation (TV).1 2 NICE guidelines recommend that patients with MND should routinely receive specialist palliative care input.3 The aim...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Gleeson A,Johnson F

    更新日期:2020-09-01 00:00:00

  • PA14 The legacy of cancer: why a health promoting approach is so important in palliative care.

    abstract:BACKGROUND:A diagnosis of cancer and anticipated death of a loved one has a significant impact on the whole family. Research has mainly focused on carers, with little emphasis on the wider, long-term implications. AIM:To explore the cancer beliefs of patients with advanced cancer and their relatives. The focus was on ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Baker N,Armour K,Meystre C,Redwood S,Dawson A

    更新日期:2015-04-01 00:00:00

  • The Spectrum of Children's Palliative Care Needs: a classification framework for children with life-limiting or life-threatening conditions.

    abstract:OBJECTIVES:This paper examined the potential of a new classification framework, The Spectrum of Children's Palliative Care Needs, to facilitate identification of children with palliative care needs for the purposes of minimum data set collection and population needs assessment. METHODS:Health and social care professio...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Shaw KL,Brook L,Mpundu-Kaambwa C,Harris N,Lapwood S,Randall D

    更新日期:2015-09-01 00:00:00

  • Provision of palliative care in National Cancer Grid treatment centres in India: a cross-sectional gap analysis survey.

    abstract:OBJECTIVES:This study aimed to identify gaps in palliative care (PC) provision across the National Cancer Grid (NCG) centres in India. METHODS:We performed a cross-sectional validated web-based survey on 102 NCG cancer centres (Nov '17 to April '18). The survey questionnaire had seven sections collecting data relating...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Damani A,Salins N,Ghoshal A,Chowdhury J,Muckaden MA,Deodhar J,Pramesh CS

    更新日期:2020-06-09 00:00:00

  • Radiation therapy in malignant spinal cord compression: what is the current knowledge on fractionation schedules? A systematic literature review.

    abstract::Malignant spinal cord compression (MSCC) in patients with short life expectancy is most frequently treated with radiotherapy and/or corticosteroids. Hypofractionation has been proven to be efficient in metastatic bone pain, but the level of evidence for hypofractionation in MSCC is limited. Searches were performed in ...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


    authors: Løhre ET,Lund JÅ,Kaasa S

    更新日期:2012-03-01 00:00:00

  • Effect of creative writing on mood in patients with cancer.

    abstract:OBJECTIVE:To determine the feasibility of conducting creative writing workshops (CWW) for patients with cancer to promote improvement in mood. METHOD:We piloted a prospective study to determine the feasibility of conducting CWW over a 4-week period. Patients were randomised 2:1 to either an intervention arm (IA) or to...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,随机对照试验


    authors: Zhu J,Hussain M,Joshi A,Truica CI,Nesterova D,Collins J,Saunders EFH,Hayes M,Drabick JJ,Joshi M

    更新日期:2020-03-01 00:00:00

  • OA2 Chinese migrant peasant workers and the contradictory demands of filial piety in neo-liberal chinese society: a case study of filial end-of-life care in langzhong city.

    abstract:BACKGROUND:Many scholars claim that recent changes to Chinese society since economic reform have challenged longstanding forms of informal social care, such as filial piety. For instance there is a societal tension at work in contemporary Chinese society today. On the one hand decreasing co-residence in multi-generatio...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: He L

    更新日期:2015-04-01 00:00:00

  • Cancer pain management in Mexico.

    abstract:BACKGROUND:Pain control is an essential component of high-quality palliative care. Unfortunately, many low-income and middle-income countries lack an appropriate infrastructure to provide palliative care and suffer from a severe lack of access to opioid analgesics to alleviate pain from various conditions such as cance...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Lincoln SB,Soto-Perez-de-Celis E,Chavarri-Guerra Y,Covarrubias-Gomez A,Navarro M,Goss PE

    更新日期:2019-10-30 00:00:00

  • Breast cancer prognosis and P-cadherin expression: systematic review and study-level meta-analysis.

    abstract:OBJECTIVE:P-cadherin can act both as a tumour suppressor and an oncogene. The clinical prognostic value of P-cadherin overexpression in breast cancer (BC) remains unclear. We conducted a study-level meta-analysis to determine whether P-cadherin expression can help predict prognosis in BC. METHODS:A systematic literatu...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


    authors: Qi R,Lin J,Chen S,Jiang J,Zhang X,Yao B,Zheng H,Jin Z,Yuan Y,Hou W,Hua B,Guo Q

    更新日期:2020-09-17 00:00:00

  • Impact of a patient-tailored complementary/integrative medicine programme on disturbed sleep quality among patients undergoing chemotherapy.

    abstract:OBJECTIVES:The present study examined the impact of a patient-tailored complementary/integrative medicine (CIM) programme on sleep quality in patients undergoing chemotherapy for breast and gynaecological cancer. METHODS:Study participants received standard supportive care, with or without weekly CIM treatments. Distu...

    journal_title:BMJ supportive & palliative care

    pub_type: 临床试验,杂志文章


    authors: Kerner H,Samuels N,Ben Moshe S,Sharabi IS,Ben-Arye E

    更新日期:2020-09-01 00:00:00

  • Rose geranium in sesame oil nasal spray: a treatment for nasal vestibulitis?

    abstract:OBJECTIVES:As a rose geranium in sesame oil spray product has been anecdotally noted to improve nasal vestibulitis symptoms, this study was designed to assess whether patients with nasal vestibulitis associated with cancer-directed therapy experienced symptomatic improvements from it. METHODS:Patients with breast canc...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Cathcart-Rake EJ,Smith D,Zahrieh D,Loprinzi CL

    更新日期:2020-12-01 00:00:00

  • Body composition and dietary intake in patients with head and neck cancer during radiotherapy: a longitudinal study.

    abstract:OBJECTIVES:To investigate the body composition and dietary intake in the patients with head and neck cancer (HNC) during radiotherapy (RT), and explore the relationship between them. METHODS:This was a prospective, longitudinal observational study. Adult patients with HNC undergoing RT between March 2017 and August 20...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章


    authors: Zhuang B,Zhang L,Wang Y,Cao Y,Shih Y,Jin S,Li H,Gong L,Wang Y,Jin S,Lu Q

    更新日期:2020-09-11 00:00:00

  • Psychological concerns of Indian women with breast cancer in different national contexts: a systematic review and mixed-methods synthesis.

    abstract:BACKGROUND:Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population. AIM:To improve understanding of psychological symptoms among Indian women with breast cancer. DESIGN:This is a syste...

    journal_title:BMJ supportive & palliative care

    pub_type: 杂志文章,评审


    authors: Daniel S,Clark J,Gnanapragasam S,Venkateswaran C,Johnson MJ

    更新日期:2020-05-11 00:00:00