Next Article in Journal
Medical Assistance in Dying for Cancer Patients One Year After Legalization: A Collaborative Approach at a Comprehensive Cancer Centre
Previous Article in Journal
Are Patient-Reported Outcomes of Physical Function a Valid Substitute for Objective Measurements?
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Current Oncology
Volume 25
Issue 5
10.3747/co.25.4021
curroncol-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles thumb_up
...
Endorse textsms
...
Comment
Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Opportunity is the Greatest Barrier to Providing Palliative Care to Advanced Colorectal Cancer Patients: A Survey of Oncology Clinicians

by
M. A. Earp
1,
Aynharan Sinnarajah
2,3,4,*,
M. Kerba
2,
P. A. Tang
2,
J. Rodriguez-Arguello
1,
S. King
5,
S. M. Watanabe
6 and
J. E. Simon
2,3,5
1
W21C Research and Innovation Centre, Cumming School of Medicine, Calgary, AB, Canada
2
Department of Oncology, University of Calgary, Calgary, AB, Canada
3
Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
4
Palliative and End of Life Care, Department of Family Medicine, University of Calgary, 710 South Tower, 1403–29th Street NW, Calgary, AB T2N 2T8, Canada
5
Division of Internal Medicine, Department of Medicine, University of Calgary, Calgary, AB, Canada
6
Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2018, 25(5), 480-485; https://doi.org/10.3747/co.25.4021
Submission received: 7 July 2018 / Revised: 4 August 2018 / Accepted: 8 September 2018 / Published: 1 October 2018

Abstract

Palliative care (pc) is part of the recommended standard of care for patients with advanced cancer. Nevertheless, delivery of pc is inconsistent. Patients who could benefit from pc services are often referred late—or not at all. In planning for improvements to oncology pc practice in our health care system, we sought to identify barriers to the provision of earlier pc, as perceived by health care providers managing patients with metastatic colorectal cancer (mcrc). We used the Michie Theoretical Domains Framework (tdf) and Behaviour Change Wheel (bcw), together with knowledge of previously identified barriers, to develop a 31-question survey. The survey was distributed by e-mail to mcrc health care providers, including physicians, nurses, and allied staff. Responses were obtained from 57 providers (40% response rate). The most frequently cited barriers were opportunity-related—specifically, lack of time, of clinic space for consultations, and of access to specialist pc staff or services. Qualitative responses revealed that resource limitations varied by cancer centre location. In urban centres, time and space were key barriers. In rural areas, access to specialist pc was the main limiter. Self-perceived capability to manage pc needs was a barrier for 40% of physicians and 30% of nurses. Motivation was the greatest facilitator, with 89% of clinicians perceiving that patients benefit from pc. Based on the Michie tdf and bcw model, interventions that best address the identified barriers are enablement and environmental restructuring. Those findings are informing the development of an intervention plan to improve oncology pc practices in a publicly funded health care system.
Keywords: palliative care; early referral; oncology care; perceptions; knowledge translation; Behaviour Change Wheel; colorectal cancer palliative care; early referral; oncology care; perceptions; knowledge translation; Behaviour Change Wheel; colorectal cancer

Share and Cite

MDPI and ACS Style

Earp, M.A.; Sinnarajah, A.; Kerba, M.; Tang, P.A.; Rodriguez-Arguello, J.; King, S.; Watanabe, S.M.; Simon, J.E. Opportunity is the Greatest Barrier to Providing Palliative Care to Advanced Colorectal Cancer Patients: A Survey of Oncology Clinicians. Curr. Oncol. 2018, 25, 480-485. https://doi.org/10.3747/co.25.4021

AMA Style

Earp MA, Sinnarajah A, Kerba M, Tang PA, Rodriguez-Arguello J, King S, Watanabe SM, Simon JE. Opportunity is the Greatest Barrier to Providing Palliative Care to Advanced Colorectal Cancer Patients: A Survey of Oncology Clinicians. Current Oncology. 2018; 25(5):480-485. https://doi.org/10.3747/co.25.4021

Chicago/Turabian Style

Earp, M. A., Aynharan Sinnarajah, M. Kerba, P. A. Tang, J. Rodriguez-Arguello, S. King, S. M. Watanabe, and J. E. Simon. 2018. "Opportunity is the Greatest Barrier to Providing Palliative Care to Advanced Colorectal Cancer Patients: A Survey of Oncology Clinicians" Current Oncology 25, no. 5: 480-485. https://doi.org/10.3747/co.25.4021

APA Style

Earp, M. A., Sinnarajah, A., Kerba, M., Tang, P. A., Rodriguez-Arguello, J., King, S., Watanabe, S. M., & Simon, J. E. (2018). Opportunity is the Greatest Barrier to Providing Palliative Care to Advanced Colorectal Cancer Patients: A Survey of Oncology Clinicians. Current Oncology, 25(5), 480-485. https://doi.org/10.3747/co.25.4021

Article Metrics

Back to TopTop