The Perceived Facilitators and Challenges of Translating a Lung Cancer Palliative Care Intervention Into Community-Based Settings

Abstract

Despite significant progress in implementing palliative care interventions for patients with cancer, few intervention studies seek health care clinicians' input before implementation of these into the community. The purpose of this study was to explore palliative care and oncology clinicians' perspectives on the perceived facilitators and challenges in meeting the quality-of-life needs of patients with lung cancer and family caregivers in community-based settings. The Reach Effectiveness Adoption Implementation Maintenance model for implementation research was used as a framework. This was a multisite qualitative study using focus group and key informant interviews. Nineteen clinicians addressed useful practices and challenges in the following areas: (a) early palliative care, (b) interdisciplinary care planning, (c) symptom management, (d) addressing psychological and social needs, and (e) providing culturally respectful care, including spiritual care. In preparation for the intervention, specific education needs and organizational challenges were revealed. Challenges included timing and staffing constraints, the need for clinician education on palliative care services to increase organizational buy-in, and education in providing spiritual support for patients and family caregivers. This research allowed investigators to understand perceptions of clinicians as they prepared to integrate palliative care in their settings. Hospice and palliative care nurses can be instrumental in implementing palliative care into community practice.

Interprofessional Perspectives on Providing Spiritual Care for Patients With Lung Cancer in Outpatient Settings

“…This article focuses on the perceived factors that facilitate and challenge oncology and palliative care clinicians in their efforts to address patients' and family caregivers' spiritual needs. The overall qualitative study and methods have been reported elsewhere (Siler, Mamier, & Winslow, 2018).…”

Clinicians’ Perception of Spirituality in Oncology Care: A Qualitative Synthesis

“…Three studies reported that in directing the spiritual needs of the patient, thereby promoting spiritual wellness and maintaining hope. Interprofessional team support is needed like doctor, nurse, social worker and chaplain [16,17,18]. The inclusion of spiritual care in quality palliative care of oncology practice is a team approach .…”

“…[16] "Chaplains are unofficially part of the group, but when we see patients and families, [the chaplain] really knows what questions to pinpoint to ask." [18]…”

“…Three studies reported that clinician provided spiritual support interventions offer hope and spiritual wellness [16,17,18,19]. The interventions identified by the clinicians other than offering prayer, are being with there and listening to patients, meditation, distraction of thoughts and music as expressed by the participants: "I encourage them to meditate or listen to music the like, just to get their heads out of the disease."…”

“…The interventions identified by the clinicians other than offering prayer, are being with there and listening to patients, meditation, distraction of thoughts and music as expressed by the participants: "I encourage them to meditate or listen to music the like, just to get their heads out of the disease." [18] "I should provide some specific help to relieve their fear about death, and talk death with them; just like the Western countries' nurses do for their patients…talk about death openly, and say goodbye with them." [17]…”