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Exploring health care professionals' perceptions regarding shared clinical decision-making in both acute and palliative cancer care
Sophiahemmet University.ORCID iD: 0000-0002-6331-8599
2022 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 19, no 23, article id 16134Article in journal (Refereed) Published
Abstract [en]

Developments in cancer care have resulted in improved survival and quality of life. Integration of acute and palliative cancer care is desirable, but not always achieved. Fragmented care is associated with sub-optimal communication and collaboration, resulting in unnecessary care transitions. The aim of this study was to explore how health care professionals, from both acute and palliative care, perceive clinical decision-making when caring for patients undergoing active cancer treatment in parallel with specialized palliative care at home.

METHODS: Qualitative explorative design, using online focus-group interviews, based on patient-cases, among health care professionals (physicians and nurses) and Framework Analysis.

RESULTS: Six online focus-group interviews were performed. Few signs of systematic integration were found, risking fragmented care, and putting the patients in a vulnerable situation. Different aspects of uncertainty related to mandates and goals-of-care impacted clinical decision-making. Organizational factors appeared to hinder mutual clinical decision-making as well as the uncertainty related to responsibilities. These uncertainties seemed to be a barrier to timely end-of-life conversations and clinical decisions on optimal care, for example, the appropriateness of transfer to acute care.

CONCLUSIONS: Lack of integration between acute and palliative care have negative consequences for patients (fragmented care), health care professionals (ethical stress), and the health care system (inadequate use of resources).

Place, publisher, year, edition, pages
2022. Vol. 19, no 23, article id 16134
Keywords [en]
Cancer care, Clinical decision-making, Clinical research home care, Focus groups, Palliative care
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-4680DOI: 10.3390/ijerph192316134PubMedID: 36498204OAI: oai:DiVA.org:shh-4680DiVA, id: diva2:1719088
Available from: 2022-12-14 Created: 2022-12-14 Last updated: 2022-12-14Bibliographically approved

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Bergkvist, Karin

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CiteExportLink to record
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Citation style
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  • de-DE
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