Palliative and Supportive Care

Original Articles

Medical oncologists' perception of palliative care programs and the impact of name change to supportive care on communication with patients during the referral process. A qualitative study

Wadih Rhondalia1a2 *, Stephanie Burta3 *, Elaine Wittenberg-Lylesa4, Eduardo Brueraa1 and Shalini Dalala1 c1

a1 Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas

a2 Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France

a3 Department of Gastroenterology, Hepatology, & Nutrition, The University of Texas M.D. Anderson Cancer Center, Houston, Texas

a4 Markey Cancer Center and Department of Communication, University of Kentucky, Lexington, Kentucky

Abstract

Objective: In a simultaneous care model, patients have concurrent access to both cancer-directed therapies and palliative care. As oncologists play a critical role in determining the need/timing of referral to palliative care programs, their understanding of the service and ability to communicate this with patients is of paramount importance. Our study aimed to examine oncologists' perceptions of the supportive care program at M.D. Anderson Cancer Center, and to determine whether renaming “palliative care” to “supportive care” influenced communication regarding referrals.

Method: This qualitative study used semi-directed interviews, and we analyzed data using grounded theory and qualitative methods.

Results: We interviewed 17 oncologists. Supportive care was perceived as an important time-saving application, and symptom control, transitioning to end-of-life care, family counseling, and improving patients' ability to tolerate cancer therapies were cited as important functions. Although most claimed that early referrals to the service are preferable, oncologists identified several challenges, related to the timing and communication with patients regarding the referral, as well as with the supportive care team after the referral was made. Whereas oncologists stated that the name change had no impact on their referral patterns, the majority supported it, as they perceived their patients preferred it.

Significance of results: Although the majority of oncologists favorably viewed supportive care, communication barriers were identified, which need further confirmation. Simultaneous care models that effectively incorporate palliative care with cancer treatments need further development.

(Received May 11 2012)

(Accepted June 10 2012)

Keywords

  • Advanced cancer;
  • Palliative care;
  • Supportive care;
  • Simultaneous care model;
  • Referral

Correspondence

c1 Address correspondence and reprint requests to: Shalini Dalal, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030. E-mail: sdalal@mdanderson.org

Footnotes

*  Authors contributed equally to this manuscript.