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Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study.

Publication ,  Journal Article
LeBlanc, TW; O'Donnell, JD; Crowley-Matoka, M; Rabow, MW; Smith, CB; White, DB; Tiver, GA; Arnold, RM; Schenker, Y
Published in: J Oncol Pract
March 2015

PURPOSE: Patients with hematologic malignancies are less likely to receive specialist palliative care services than patients with solid tumors. Reasons for this difference are poorly understood. METHODS: This was a multisite, mixed-methods study to understand and contrast perceptions of palliative care among hematologic and solid tumor oncologists using surveys assessing referral practices and in-depth semistructured interviews exploring views of palliative care. We compared referral patterns using standard statistical methods. We analyzed qualitative interview data using constant comparative methods to explore reasons for observed differences. RESULTS: Among 66 interviewees, 23 oncologists cared exclusively for patients with hematologic malignancies; 43 treated only patients with solid tumors. Seven (30%) of 23 hematologic oncologists reported never referring to palliative care; all solid tumor oncologists had previously referred. In qualitative analyses, most hematologic oncologists viewed palliative care as end-of-life care, whereas most solid tumor oncologists viewed palliative care as a subspecialty that could assist with complex patient cases. Solid tumor oncologists emphasized practical barriers to palliative care referral, such as appointment availability and reimbursement issues. Hematologic oncologists emphasized philosophic concerns about palliative care referrals, including different treatment goals, responsiveness to chemotherapy, and preference for controlling even palliative aspects of patient care. CONCLUSION: Most hematologic oncologists view palliative care as end-of-life care, whereas solid tumor oncologists more often view palliative care as a subspecialty for comanaging patients with complex cases. Efforts to integrate palliative care into hematologic malignancy practices will require solutions that address unique barriers to palliative care referral experienced by hematologic malignancy specialists.

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Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

March 2015

Volume

11

Issue

2

Start / End Page

e230 / e238

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Specialization
  • Practice Patterns, Physicians'
  • Perception
  • Palliative Care
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Oncology
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
LeBlanc, T. W., O’Donnell, J. D., Crowley-Matoka, M., Rabow, M. W., Smith, C. B., White, D. B., … Schenker, Y. (2015). Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study. J Oncol Pract, 11(2), e230–e238. https://doi.org/10.1200/JOP.2014.001859
LeBlanc, Thomas W., Jonathan D. O’Donnell, Megan Crowley-Matoka, Michael W. Rabow, Cardinale B. Smith, Douglas B. White, Greer A. Tiver, Robert M. Arnold, and Yael Schenker. “Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study.J Oncol Pract 11, no. 2 (March 2015): e230–38. https://doi.org/10.1200/JOP.2014.001859.
LeBlanc TW, O’Donnell JD, Crowley-Matoka M, Rabow MW, Smith CB, White DB, et al. Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study. J Oncol Pract. 2015 Mar;11(2):e230–8.
LeBlanc, Thomas W., et al. “Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study.J Oncol Pract, vol. 11, no. 2, Mar. 2015, pp. e230–38. Pubmed, doi:10.1200/JOP.2014.001859.
LeBlanc TW, O’Donnell JD, Crowley-Matoka M, Rabow MW, Smith CB, White DB, Tiver GA, Arnold RM, Schenker Y. Perceptions of palliative care among hematologic malignancy specialists: a mixed-methods study. J Oncol Pract. 2015 Mar;11(2):e230–e238.

Published In

J Oncol Pract

DOI

EISSN

1935-469X

Publication Date

March 2015

Volume

11

Issue

2

Start / End Page

e230 / e238

Location

United States

Related Subject Headings

  • Surveys and Questionnaires
  • Specialization
  • Practice Patterns, Physicians'
  • Perception
  • Palliative Care
  • Oncology & Carcinogenesis
  • Middle Aged
  • Medical Oncology
  • Male
  • Humans