'The horse has bolted I suspect': A qualitative study of clinicians' attitudes and perceptions regarding palliative rehabilitation.
BACKGROUND
Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied.


OBJECTIVE
To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units.


METHODS
Qualitative study utilizing semi-structured interviews. Transcribed interviews were analysed using thematic analysis and major themes reported as results.


METHODS
Australian palliative medicine physicians working in inpatient palliative care units.


RESULTS
In total, 20 physicians participated, representing specialist palliative care services across Australia. A total of 11 (55%) were males with an average of 12.5 years' experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care; however, few felt adequate rehabilitation programmes were available. Participants varied in their concepts of what palliative rehabilitation entailed. The term rehabilitation was seen by some as helpful (fostering hope and aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians' attitudes, including (1) integrating rehabilitation within palliative care, (2) the intervention, (3) possibilities and (4) the message of rehabilitation.


CONCLUSIONS
A lack of consensus exists among palliative medicine specialists regarding the definition and scope of palliative rehabilitation. Participants generally expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base for palliative rehabilitation, to support its acceptance and widespread integration within specialist inpatient palliative care.
1 Department of Palliative Care, Calvary Health Care Bethlehem, Melbourne, VIC, Australia.|2 Supportive and Palliative Care Unit, Monash Health, Melbourne, VIC, Australia.|3 The University of Notre Dame, Darlinghurst, NSW, Australia.|4 Monash University, Melbourne, VIC, Australia.
Fiona
F
Runacres
1 Department of Palliative Care, Calvary Health Care Bethlehem, Melbourne, VIC, Australia.|3 The University of Notre Dame, Darlinghurst, NSW, Australia.
Heidi
H
Gregory
5 Deakin University, Geelong, VIC, Australia.|6 Cancer Council Victoria, Melbourne, VIC, Australia.
Anna
A
Ugalde
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D036301:Qualitative Research; D012046:Rehabilitation / Q000523:psychology*
Palliative care; hospice care; rehabilitation