title: Doctors' understanding of palliative care.
abstract: Palliative care has been challenged to share its message with a wider audience, and for many years it has been articulating an approach that is suitable for all patients. However, it is not clear how widely this message has been accepted. As part of a study into end-of-life care for heart failure, we conducted seven focus groups with doctors in general practice, palliative medicine, cardiology, geriatrics and general medicine. In these, we explored doctors' understanding of palliative care. Participants displayed a reasonable grasp of the wider concept of palliative care, but the specialists' role was ill-defined, reflected in scepticism about their place outside of cancer. Perceptions of palliative care fell into three broad areas: it was more than a service, about managing dying, and the concern of nurses, rather than doctors. Palliative care was welcomed as providing permission to fail, whilst representing a dilemma between quantity and quality of life for the interviewees. Our work suggests that specialist palliative care has been partially successful in getting their message across, and poor understanding or receptivity are not major barriers to implementing palliative care. Educational or other interventions to implement change in palliative care need to acknowledge the complex interaction of factors influencing physicians' behaviour.
authors.affiliation: Division of Public Health, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK. b.hanratty@liverpool.ac.uk
authors.forename: Barbara
authors.initials: B
authors.lastname: Hanratty
authors.forename: Derek
authors.initials: D
authors.lastname: Hibbert
authors.forename: Frances
authors.initials: F
authors.lastname: Mair
authors.forename: Carl
authors.initials: C
authors.lastname: May
authors.forename: Chris
authors.initials: C
authors.lastname: Ward
authors.forename: Ged
authors.initials: G
authors.lastname: Corcoran
authors.forename: Simon
authors.initials: S
authors.lastname: Capewell
authors.forename: Andrea
authors.initials: A
authors.lastname: Litva
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003695:Delivery of Health Care / Q000592:standards*; D017144:Focus Groups; D006333:Heart Failure / Q000451:nursing*; D006801:Humans; D010166:Palliative Care / Q000523:psychology / Q000592:standards*; D010819:Physician's Role; D013727:Terminal Care / Q000523:psychology / Q000592:standards*