Clinicians' experiences, perspectives, barriers, and facilitators of integrating palliative care into hematological malignancy care: a qualitative interview study

Abstract

PURPOSE: Palliative care is integrated into hematological malignancy care less frequently than in the care for patients with solid tumors. Therefore, this study aimed to better understand the perspectives and experiences of clinicians regarding integrating palliative care for patients with hematological malignancies. METHODS: Interviews were conducted with clinicians who care for hematological patients. The interviews were analyzed using thematic analysis. RESULTS: Participants acknowledged the importance of integrating palliative care. However, they noted that patients with hematological malignancies often have a more unpredictable disease course than patients with solid tumors. Unpredictability and the potential for rapid deterioration were identified as main barriers to the integration of palliative care. In addition, participants indicated that the availability of multiple treatment options may result in a tendency to prioritize these treatments over integrating palliative care. The participants recommended that palliative care should have a prominent position in the hematology curriculum and suggested that including palliative care topics in conferences could enhance awareness. CONCLUSIONS: To integrate palliative care into hematological malignancy care, it is necessary to enhance the knowledge and awareness of palliative care among hematological clinicians. A two-track approach, where both curative and palliative pathways coexist, could facilitate the integration of palliative care.