Medical specialists’ motivations for referral to specialist palliative care: a qualitative study

Kirby, Emma, Broom, Alex, Good, Philip, Wootton, Julia and Adams, Jon (2013) Medical specialists’ motivations for referral to specialist palliative care: a qualitative study. BMJ Supportive and Palliative Care, 4 3: 277-284. doi:10.1136/bmjspcare-2012-000376

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Author Kirby, Emma
Broom, Alex
Good, Philip
Wootton, Julia
Adams, Jon
Title Medical specialists’ motivations for referral to specialist palliative care: a qualitative study
Journal name BMJ Supportive and Palliative Care   Check publisher's open access policy
ISSN 2045-435X
Publication date 2013
Year available 2012
Sub-type Article (original research)
DOI 10.1136/bmjspcare-2012-000376
Open Access Status
Volume 4
Issue 3
Start page 277
End page 284
Total pages 8
Place of publication London, United Kingdom
Publisher BMJ Group
Collection year 2013
Language eng
Formatted abstract
Objectives The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists’ motivations and triggers underpinning decision-making around referral to palliative care in order to facilitate improvements in referral practices.
Methods We completed semistructured, qualitative interviews with 20 referring medical specialists. Medical specialists were recruited from a range of specialties in a major metropolitan area in Australia. Participants were sampled through having referred at least one patient to the specialist palliative care unit during the previous 12 months. Analysis consisted of the framework approach augmented by NVivo 9 data analysis software. Key themes were identified and tested for rigour through inter-rater reliability and constant comparison.
Results The major motivations/triggers identified were: (a) disease-based (eg, pain management and symptom control); (b) pre-emptive/strategic (eg, anticipation of need, preparatory objective); (c) crisis/parallel (eg, physical and psychosocial issues); and (d) team-based (eg, referral as policy/team strategy).
Conclusions Referral to palliative care is motivated by a range of individual, interpersonal and organisational factors. In order to improve the care and quality of life of patients and family caregivers, further work is needed to develop streamlined practices that are sensitive to physical and psychosocial considerations, and patient/family caregiver desires.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published Online First: 14 December 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Social Science Publications
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Citation counts: Scopus Citation Count Cited 3 times in Scopus Article | Citations
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Created: Wed, 27 Feb 2013, 12:08:50 EST by Emma Kirby on behalf of School of Social Science