Barriers to the Collaboration Between Hematologists and Palliative Care Teams on Relapse or Refractory Leukemia and Malignant Lymphoma Patients' Care: A Qualitative Study.
BACKGROUND
Palliative care service (PCS) has been shown to be utilized less in patients with leukemia and malignant lymphoma than in those with solid tumors. Previous studies have suggested hematologists' limited awareness of PCS as one of the reason for low PCS referral in hematology. However, little is known about such an awareness and potential barriers to collaboration between hematologists and PCS.


OBJECTIVE
The present study aimed to assess ematologists and palliative care specialists' perception about the roles of the hospital-based palliative care team (HPCT) and the barriers to collaboration between hematologists and palliative care teams on relapse or refractory leukemia and malignant lymphoma patients' care MATERIALS AND METHODS: A qualitative study was conducted using semistructured interviews with hematologists and palliative care specialists recruited from a hospital that provides hematology and palliative care by the HPCT. Data were evaluated via content analysis.


RESULTS
The study included 11 hematologists and 10 palliative care specialists. Our results revealed that they shared many common perceptions about the roles and expectations of the HPCT. Additionally, 7 categories of barriers to collaboration were identified, including not feeling the need to refer, the difficulty in referral timing, the lack of aggressive approach, the negative image of the HPCT, the need for hematologic malignancy-oriented management, the lack of communication, and others.


CONCLUSIONS
We have identified hematologists' and palliative care specialists' perceptions of the HPCT's roles and the barriers to their collaboration. A better understanding of such barriers may lead to effective collaboration between hematologists and the HPCT.
The Jikei University Hospital, Tokyo, Japan morikawamh@jikei.ac.jp.|Certified Nurse Specialist Course in Cancer Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Miharu
M
Morikawa
School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.|Asoka Vihara Hospital, Kyoto, Japan.
Yuki
Y
Shirai
School of Medicine Nursing Course, Yokohama City University, Yokohama, Japan.
Ryota
R
Ochiai
Laboratory of Molecular Radiology, Center for Disease Biology and Integrative Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kiyoshi
K
Miyagawa
D000328:Adult; D001291:Attitude of Health Personnel; D003142:Communication; D003299:Cooperative Behavior; D005260:Female; D019337:Hematologic Neoplasms / Q000523:psychology / Q000628:therapy*; D006405:Hematology / Q000458:organization & administration*; D006801:Humans; D007938:Leukemia / Q000523:psychology / Q000628:therapy; D008223:Lymphoma / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team; D036301:Qualitative Research; D012008:Recurrence
communication barriers; leukemia; lymphoma; palliative care; palliative care team; referral and consultation