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How views of Oncologists and Haematologists impacts Palliative Care Referral: A Systematic Review

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How views of Oncologists and Haematologists impacts Palliative Care Referral: A Systematic Review. / Salins, Naveen; Ghoshal, Arunangshu; Hughes, Sean et al.
In: BMC Palliative Care, Vol. 19, 175, 23.11.2020.

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Salins N, Ghoshal A, Hughes S, Preston N. How views of Oncologists and Haematologists impacts Palliative Care Referral: A Systematic Review. BMC Palliative Care. 2020 Nov 23;19:175. doi: 10.1186/s12904-020-00671-5

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Salins, Naveen ; Ghoshal, Arunangshu ; Hughes, Sean et al. / How views of Oncologists and Haematologists impacts Palliative Care Referral : A Systematic Review. In: BMC Palliative Care. 2020 ; Vol. 19.

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@article{ce19b69efd094cef8a3e40d621bf42d1,
title = "How views of Oncologists and Haematologists impacts Palliative Care Referral: A Systematic Review",
abstract = "Background: Worldwide, many patients with cancer, are infrequently referred to palliative care or are referred late. Oncologists and haematologists may act as gatekeepers, and their views may facilitate or hinder referrals to palliative care. This review aimed to identify, explore and synthesise their views on referrals systematically. Methods: Databases of MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science and Cochrane were searched for articles from 01/01/1990 to 31/12/2019. All studies were scored for their methodological rigour using Hawker{\textquoteright}s tool. Findings were synthesised using Popay{\textquoteright}s narrative synthesis method and interpreted using a critical realist lens and social exchange theory. Results: Out of 9336 initial database citations, 23 studies were included for synthesis. Five themes were developed during synthesis. 1. Presuppositions of oncologists and haematologists about palliative care referral: Role conflict, abandonment, rupture of therapeutic alliance and loss of hope were some of the presuppositions that hindered palliative care referral. Negative emotions and perception of self-efficacy to manage palliative care need also hindered referral.2. Power relationships and trust issues: Oncologists and haematologists preferred to gatekeep the referral process and wished to control and coordinate the care process. They had diminished trust in the competency of palliative care providers.3. Making a palliative care referral: A daunting task: The stigma associated with palliative care, navigating illness and treatment associated factors, addressing patient and family attitudes, and overcoming organisational challenges made referral a daunting task. Lack of referral criteria and limited palliative care resources made the referral process challenging.4. Cost-benefit of palliative care referral: Pain and symptom management and psychosocial support were the perceived benefits, whereas inconsistencies in communication and curtailment of care were some of the costs associated with palliative care referral. 5. Strategies to facilitate palliative care referral: Developing an integrated model of care, renaming and augmenting palliative care resources were some of the strategies that could facilitate a referral. Conclusion: Presuppositions, power relationships, trust issues and the challenges associated with the task of referrals hindered palliative care referral. Oncologists and haematologists appraised the cost-benefit of making a palliative care referral. They felt that an integrated model of care, changing the name of palliative care and augmenting palliative care resources might facilitate a referral.Keywords: Haematologists, Oncologists, Palliative Care, Referral, Views ",
keywords = "Haematologists, Oncologists, Palliative Care, Referral",
author = "Naveen Salins and Arunangshu Ghoshal and Sean Hughes and Nancy Preston",
year = "2020",
month = nov,
day = "23",
doi = "10.1186/s12904-020-00671-5",
language = "English",
volume = "19",
journal = "BMC Palliative Care",
issn = "1472-684X",
publisher = "BIOMED CENTRAL LTD",

}

RIS

TY - JOUR

T1 - How views of Oncologists and Haematologists impacts Palliative Care Referral

T2 - A Systematic Review

AU - Salins, Naveen

AU - Ghoshal, Arunangshu

AU - Hughes, Sean

AU - Preston, Nancy

PY - 2020/11/23

Y1 - 2020/11/23

N2 - Background: Worldwide, many patients with cancer, are infrequently referred to palliative care or are referred late. Oncologists and haematologists may act as gatekeepers, and their views may facilitate or hinder referrals to palliative care. This review aimed to identify, explore and synthesise their views on referrals systematically. Methods: Databases of MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science and Cochrane were searched for articles from 01/01/1990 to 31/12/2019. All studies were scored for their methodological rigour using Hawker’s tool. Findings were synthesised using Popay’s narrative synthesis method and interpreted using a critical realist lens and social exchange theory. Results: Out of 9336 initial database citations, 23 studies were included for synthesis. Five themes were developed during synthesis. 1. Presuppositions of oncologists and haematologists about palliative care referral: Role conflict, abandonment, rupture of therapeutic alliance and loss of hope were some of the presuppositions that hindered palliative care referral. Negative emotions and perception of self-efficacy to manage palliative care need also hindered referral.2. Power relationships and trust issues: Oncologists and haematologists preferred to gatekeep the referral process and wished to control and coordinate the care process. They had diminished trust in the competency of palliative care providers.3. Making a palliative care referral: A daunting task: The stigma associated with palliative care, navigating illness and treatment associated factors, addressing patient and family attitudes, and overcoming organisational challenges made referral a daunting task. Lack of referral criteria and limited palliative care resources made the referral process challenging.4. Cost-benefit of palliative care referral: Pain and symptom management and psychosocial support were the perceived benefits, whereas inconsistencies in communication and curtailment of care were some of the costs associated with palliative care referral. 5. Strategies to facilitate palliative care referral: Developing an integrated model of care, renaming and augmenting palliative care resources were some of the strategies that could facilitate a referral. Conclusion: Presuppositions, power relationships, trust issues and the challenges associated with the task of referrals hindered palliative care referral. Oncologists and haematologists appraised the cost-benefit of making a palliative care referral. They felt that an integrated model of care, changing the name of palliative care and augmenting palliative care resources might facilitate a referral.Keywords: Haematologists, Oncologists, Palliative Care, Referral, Views

AB - Background: Worldwide, many patients with cancer, are infrequently referred to palliative care or are referred late. Oncologists and haematologists may act as gatekeepers, and their views may facilitate or hinder referrals to palliative care. This review aimed to identify, explore and synthesise their views on referrals systematically. Methods: Databases of MEDLINE, CINAHL, PsycINFO, EMBASE, Scopus, Web of Science and Cochrane were searched for articles from 01/01/1990 to 31/12/2019. All studies were scored for their methodological rigour using Hawker’s tool. Findings were synthesised using Popay’s narrative synthesis method and interpreted using a critical realist lens and social exchange theory. Results: Out of 9336 initial database citations, 23 studies were included for synthesis. Five themes were developed during synthesis. 1. Presuppositions of oncologists and haematologists about palliative care referral: Role conflict, abandonment, rupture of therapeutic alliance and loss of hope were some of the presuppositions that hindered palliative care referral. Negative emotions and perception of self-efficacy to manage palliative care need also hindered referral.2. Power relationships and trust issues: Oncologists and haematologists preferred to gatekeep the referral process and wished to control and coordinate the care process. They had diminished trust in the competency of palliative care providers.3. Making a palliative care referral: A daunting task: The stigma associated with palliative care, navigating illness and treatment associated factors, addressing patient and family attitudes, and overcoming organisational challenges made referral a daunting task. Lack of referral criteria and limited palliative care resources made the referral process challenging.4. Cost-benefit of palliative care referral: Pain and symptom management and psychosocial support were the perceived benefits, whereas inconsistencies in communication and curtailment of care were some of the costs associated with palliative care referral. 5. Strategies to facilitate palliative care referral: Developing an integrated model of care, renaming and augmenting palliative care resources were some of the strategies that could facilitate a referral. Conclusion: Presuppositions, power relationships, trust issues and the challenges associated with the task of referrals hindered palliative care referral. Oncologists and haematologists appraised the cost-benefit of making a palliative care referral. They felt that an integrated model of care, changing the name of palliative care and augmenting palliative care resources might facilitate a referral.Keywords: Haematologists, Oncologists, Palliative Care, Referral, Views

KW - Haematologists

KW - Oncologists

KW - Palliative Care

KW - Referral

U2 - 10.1186/s12904-020-00671-5

DO - 10.1186/s12904-020-00671-5

M3 - Journal article

VL - 19

JO - BMC Palliative Care

JF - BMC Palliative Care

SN - 1472-684X

M1 - 175

ER -