A multicenter survey on the perception of palliative care among the health professionals working in hematology

Abstract

Introduction Patients with hematological malignancies have less access to Palliative Care and have more delayed referrals than patients with solid tumors. Why does this occur? This survey aims to analyze the perceptions of Palliative Care of health professionals who treat hematological patients and to identify the barriers and facilitators when patients are referred to Palliative Care services. Method This is a multicenter, exploratory, descriptive web-based survey. A questionnaire was submitted to the medical and nursing staff at five Italian Hematological units and San Marino’s hospital. The survey covered accessibility, knowledge, education, perceived barriers and facilitators, and personal experiences concerning Palliative Care. Quantitative and qualitative analyses were performed. Results The number of completed questionnaires was 142/320: 96 by nurses and 46 by physicians. It emerged that 96.5% of participants supported integration of hematology and Palliative Care. It was found that 50.7% of participants had a Palliative Care team at their hospital, though only 16.2% had attended a specific course within their hospital, and 70.4% of them were familiar with the role of a palliativist. Nearly half of professionals (49.2%) agreed to refer patients to Palliative Care at the beginning of the care pathway, 52.8% when the prognosis is less than three months or with incoercible symptoms. The percentages of physicians and nurses agreeing to transfusions even in the final stages of the disease were 60.9% and 55.3%, respectively. Concerning facilitators, 65.5% of physicians and 47.2% of nurses considered an in-hospital Palliative Care team and a case manager to be fundamental; 82.4% of participants highlighted the importance of Palliative Care training. Conclusion The results show that professionals have a positive attitude towards achieving multidisciplinary integration. The small number of referrals may be due to clinical, cultural, educational, organizational, and resource issues.