Clinician roles in early integrated palliative care for patients with advanced cancer: a qualitative study.
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.
1 Fred Hutchinson Cancer Research Center, University of Washington , Seattle, Washington.
Anthony L
AL
Back
Elyse R
ER
Park
Joseph A
JA
Greer
Vicki A
VA
Jackson
Juliet C
JC
Jacobsen
Emily R
ER
Gallagher
Jennifer S
JS
Temel
D000223:Adaptation, Psychological; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007407:Interviews as Topic; D008175:Lung Neoplasms / Q000473:pathology* / Q000523:psychology / Q000628:therapy*; D008297:Male; D010045:Outpatients; D010166:Palliative Care / Q000458:organization & administration*; D024382:Professional Role; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life