A qualitative study exploring patient, family carer and healthcare professional perceptions of providing palliative care for advanced head and neck cancer

Abstract

Purpose: To explore patient, family carer and healthcare professionals’ perspectives about providing palliative care for advanced head and neck cancer patients and potential components which could inform a future model of care. Methods: Using a naturalistic, interpretative approach, within Northwest England, a purposive sample of adult head and neck cancer patients was selected. Their family carers were also invited to participate. Healthcare professionals (representing head and neck surgery and specialist nursing; oncology; specialist palliative care; general practice and community nursing) were recruited. All participants underwent face-to-face or telephone interviews. A thematic approach, using a modified version of Colazzi’s framework, was used to analyse the data. Results: In total, 17 interviews were conducted (nine patients, four joint with family carers and eight healthcare professionals). Three main themes relating to challenges in providing palliative care were identified: the ‘need for support at critical moments’ in the patients’ disease trajectory; ‘communication challenges’ and ‘complexity of decision-making’. Additionally, three themes related to key components to inform a future model of care: ‘partnership model’; ‘timely and responsive engagement of Specialist Palliative Care’; and ‘good linkage and connections’. Conclusions: Conceptually, the identified ‘critical moments’ in the patients’ disease trajectory should be a focus for future interventions to help improve and support care. These interventions should direct improvements in the provision of information and psychological support. Models of palliative care for this population need to be developed in partnership with existing services to ensure care is delivered in a coordinated and timely manner.