title: Interviews with Irish healthcare workers from different disciplines about palliative care for people with Parkinson's disease: a definite role but uncertainty around terminology and timing.
abstract: BACKGROUND
  An integrated palliative care approach is recommended in all life-limiting diseases, including Parkinson's disease (PD). However research shows that people with PD have unmet palliative care needs. The study aimed to explore multidisciplinary healthcare workers' (HCWs) views on palliative care for people with PD, identifying perceived barriers and facilitators.
  
  
  METHODS
  A qualitative design was used; data was analysed using Thematic Analysis. Semi-structured interviews were conducted with 30 HCWs, working either with people with PD or in a palliative care setting in Ireland.
  
  
  RESULTS
  A number of perceived barriers were evident helping to account for the previously reported unmet palliative care needs in PD. A lack of education about PD and palliative care meant that HCWs were unsure of the appropriateness of referral, and patients and carers weren't equipped with information to seek palliative care. A lack of communication between PD and palliative care specialists was seen to impede collaboration between the disciplines. Uncertainty about the timing of palliative care meant that it was often not introduced until a crisis point, despite the recognised need for early planning due to increased prevalence of dementia.
  
  
  CONCLUSIONS
  Most HCWs recognised a need for palliative care for people with PD; however several barriers to implementing a palliative care approach in this population need to be addressed. Implications for clinical practice and policy include the need for an integrated model of care, and education for all HCWs, patients, carers, and the public on both the nature of advanced PD, and the potential of palliative care in support of patients and their family members.
authors: Centre for Gerontology and Rehabilitation, St. Finbarr's Hospital, Douglas Road, Cork City, Ireland. s.fox@ucc.ie.
authors: Siobhan
authors: S
authors: Fox
authors: Parkinson's Association of Ireland, Dublin, Ireland. alicashell@gmail.com.
authors: Alison
authors: A
authors: Cashell
authors: Institute of Nursing and Health Research, University of Ulster, Co., Antrim, UK. wg.kernohan@ulster.ac.uk.
authors: W George
authors: WG
authors: Kernohan
authors: Irish Hospice Foundation, Dublin, Ireland. marie.lynch@hospice-foundation.ie.
authors: Marie
authors: M
authors: Lynch
authors: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland. ciaramcglade@gmail.com.
authors: Ciara
authors: C
authors: McGlade
authors: Marymount University Hospital and Hospice, Co., Cork, Ireland. tony.obrien1@hse.ie.
authors: Tony
authors: T
authors: O'Brien
authors: Cork University Hospital, Cork, Ireland. Sean.osullivan@hse.ie.
authors: Sean S
authors: SS
authors: O'Sullivan
authors: Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland. s.timmons@ucc.ie.
authors: Suzanne
authors: S
authors: Timmons
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D017144:Focus Groups; D006282:Health Personnel; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D010300:Parkinson Disease / Q000628:therapy*; D036301:Qualitative Research; D013997:Time Factors; D035501:Uncertainty