Integrating generalist palliative care within oncology practice – A mixed methods study exploring the knowledge and views of specialist oncology care providers working in hospitals.
General palliative care, palliative approach, oncology, cancer
For over twenty years, Irish policy has stated that providing palliative care is the responsibility of all healthcare professionals (called generalist palliative care). Ireland has an aging population and the numbers of people with palliative care needs is rapidly rising. People with advanced cancer have significant palliative care needs; however, most will be referred to specialist palliative care services very late in the course of their illness. Therefore, a workforce equipped to provide generalist palliative care is essential to address the unmet needs of people living with advanced cancer. However, little is known about how generalist palliative care is currently integrated in oncology practice, and oncology professionals report significant barriers integrating generalist palliative care within their practice in hospital settings.
Aim and objectives
To understand the experiences and challenges of specialist oncology providers in integrating generalist palliative care within their practice in hospitals. Findings will be benchmarked against existing national guidance associated with generalist palliative care provision. Knowledge will be used to identify recommendations to support oncology education and practice.
Methods
This mixed methods study utilises an exploratory sequential design. A survey instrument will be co-designed by a collaboration of academics, clinicians, and patient and public (PPI) collaborators. Healthcare providers working within specialist oncology in hospitals will participate in an online survey to determine their knowledge and understanding of their role in palliative care provision, and their familiarity with current national guidance. A workshop with PPI members will be held to explore the survey findings. Following this, focus groups will be conducted to explore barriers, facilitators and educational needs associated with integrating generalist (level 2) palliative care in oncology care.
This project recognises the importance of involving key stakeholders as active partners in the research. Within the scope of this study, key stakeholders include healthcare professionals working in oncology, palliative care, advocacy professionals, people living with cancer and their family members and caregivers. Key stakeholders with professional expertise in specialist oncology and specialist palliative care were consulted in the development of the project research objectives, and the preparation and drafting of this proposal.
The project’s expert advisory group oversees the project and consists of academics, representatives from specialist palliative care, specialist oncology care, a patient representative, hospital end-of-life care co-ordination, a palliative care advocacy organisation, and PPI Ignite DCU.
The advisory group are currently co-designing the survey instrument, and a PPI consultation workshop will be held following survey data analysis to provide feedback which will be incorporated into the analysis and subsequent focus groups. PPI members will be invited to attend and contribute to public dissemination activities associated with the findings from this research.
A peer reviewed paper produced from this research (May et al. 2020) was used by the Department of Health to inform palliative care expenditure profiles within the ‘Spending review 2021: Impact of demographic change on health expenditure 2022-2025’, July 2021 paper.
The project commenced in January 2023, and will conclude in December 2024
Dr Mary Nevin, School of Nursing, Psychotherapy and Community Health, Dublin City University
Dr Amanda Drury, School of Nursing, Psychotherapy and Community Health, Dublin City University
Dr Eileen Furlong, School of Nursing, Midwifery and Health Systems, University College Dublin
Dr Regina McQuillan, Palliative Medicine consultant at St Francis Hospice and Beaumont Hospital Dublin
Dr Virpi Sulosaari, Turku University of Applied Sciences, Finland
Prof Sheila Payne, Faculty of Health and Medicine, Lancaster University
All Ireland Institute of Hospice and Palliative Care
Voices4Care patient representative
DCU PPI Ignite
Gillian Rufli, End-Of-Life-Care Coordinator, Beaumont Hospital
Liz O’Connell, Oncology Advanced Nurse Practitioner, Tallaght University Hospital
The project is funded by the Irish Cancer Society
Guidance[PIP-CPC criteria]: for medicines for the relief of symptoms c
Email: mary.nevin@dcu.ie
