Exploring Health Care Professionals’ Perceptions Regarding Shared Clinical Decision-Making in Both Acute and Palliative Cancer Care

Helena Ullgren (), Lena Sharp, Per Fransson and Karin Bergkvist
Additional contact information
Helena Ullgren: Department of Nursing, Umeå University, 901 87 Umeå, Sweden
Lena Sharp: Department of Nursing, Umeå University, 901 87 Umeå, Sweden
Per Fransson: Department of Nursing, Umeå University, 901 87 Umeå, Sweden
Karin Bergkvist: Department of Nursing Science, Sophiahemmet University, 114 86 Stockholm, Sweden

IJERPH, 2022, vol. 19, issue 23, 1-17

Abstract: Developments in cancer care have resulted in improved survival and quality of life. Integration of acute and palliative cancer care is desirable, but not always achieved. Fragmented care is associated with sub-optimal communication and collaboration, resulting in unnecessary care transitions. The aim of this study was to explore how health care professionals, from both acute and palliative care, perceive clinical decision-making when caring for patients undergoing active cancer treatment in parallel with specialized palliative care at home. Methods: Qualitative explorative design, using online focus-group interviews, based on patient-cases, among health care professionals (physicians and nurses) and Framework Analysis. Results: Six online focus-group interviews were performed. Few signs of systematic integration were found, risking fragmented care, and putting the patients in a vulnerable situation. Different aspects of uncertainty related to mandates and goals-of-care impacted clinical decision-making. Organizational factors appeared to hinder mutual clinical decision-making as well as the uncertainty related to responsibilities. These uncertainties seemed to be a barrier to timely end-of-life conversations and clinical decisions on optimal care, for example, the appropriateness of transfer to acute care. Conclusions: Lack of integration between acute and palliative care have negative consequences for patients (fragmented care), health care professionals (ethical stress), and the health care system (inadequate use of resources).

Keywords: cancer care; palliative care; clinical decision-making; clinical research home care; focus groups (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/23/16134/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/23/16134/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:23:p:16134-:d:991447

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().