Medical specialists' motivations for referral to specialist palliative care: A qualitative study

Kirby, E; Broom, A; Good, P; Wootton, J; Adams, J

Medical specialists' motivations for referral to specialist palliative care: A qualitative study

Kirby, E Broom, A

Good, P

Wootton, J Adams, J

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Publication Type:: Journal Article
Citation:: BMJ Supportive and Palliative Care, 2014, 4 (3), pp. 277 - 284
Issue Date:: 2014-01-01

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Field	Value	Language
dc.contributor.author	Kirby, E	en_US
dc.contributor.author	Broom, A https://orcid.org/0000-0003-1258-1140	en_US
dc.contributor.author	Good, P https://orcid.org/0000-0002-8198-0375	en_US
dc.contributor.author	Wootton, J	en_US
dc.contributor.author	Adams, J https://orcid.org/0000-0002-9901-5717	en_US
dc.date.issued	2014-01-01	en_US
dc.identifier.citation	BMJ Supportive and Palliative Care, 2014, 4 (3), pp. 277 - 284	en_US
dc.identifier.issn	2045-435X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/43615
dc.description.abstract	Objectives: The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists' motivations and triggers underpinning decisionmaking around referral to palliative care in order to facilitate improvements in referral practices. Methods: We completed semistructured, qualitative interviews with 20 referring medical specialists. Medical specialists were recruited from a range of specialties in a major metropolitan area in Australia. Participants were sampled through having referred at least one patient to the specialist palliative care unit during the previous 12 months. Analysis consisted of the framework approach augmented by NVivo 9 data analysis software. Key themes were identified and tested for rigour through interrater reliability and constant comparison. Results: The major motivations/triggers identified were: (a) disease-based (eg, pain management and symptom control); (b) pre-emptive/strategic (eg, anticipation of need, preparatory objective); (c) crisis/parallel (eg, physical and psychosocial issues); and (d) team-based (eg, referral as policy/team strategy). Conclusions: Referral to palliative care is motivated by a range of individual, interpersonal and organisational factors. In order to improve the care and quality of life of patients and family caregivers, further work is needed to develop streamlined practices that are sensitive to physical and psychosocial considerations, and patient/ family caregiver desires.	en_US
dc.relation.ispartof	BMJ Supportive and Palliative Care	en_US
dc.relation.isbasedon	10.1136/bmjspcare-2012-000376	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Palliative Care	en_US
dc.subject.mesh	Attitude of Health Personnel	en_US
dc.subject.mesh	Motivation	en_US
dc.subject.mesh	Decision Making	en_US
dc.subject.mesh	Medicine	en_US
dc.subject.mesh	Referral and Consultation	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.title	Medical specialists' motivations for referral to specialist palliative care: A qualitative study	en_US
dc.type	Journal Article
utslib.citation.volume	3	en_US
utslib.citation.volume	4	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1110 Nursing	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	closed_access
pubs.issue	3	en_US
pubs.publication-status	Published	en_US
pubs.volume	4	en_US

Abstract:

Objectives: The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists' motivations and triggers underpinning decisionmaking around referral to palliative care in order to facilitate improvements in referral practices. Methods: We completed semistructured, qualitative interviews with 20 referring medical specialists. Medical specialists were recruited from a range of specialties in a major metropolitan area in Australia. Participants were sampled through having referred at least one patient to the specialist palliative care unit during the previous 12 months. Analysis consisted of the framework approach augmented by NVivo 9 data analysis software. Key themes were identified and tested for rigour through interrater reliability and constant comparison. Results: The major motivations/triggers identified were: (a) disease-based (eg, pain management and symptom control); (b) pre-emptive/strategic (eg, anticipation of need, preparatory objective); (c) crisis/parallel (eg, physical and psychosocial issues); and (d) team-based (eg, referral as policy/team strategy). Conclusions: Referral to palliative care is motivated by a range of individual, interpersonal and organisational factors. In order to improve the care and quality of life of patients and family caregivers, further work is needed to develop streamlined practices that are sensitive to physical and psychosocial considerations, and patient/ family caregiver desires.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/43615