Themes | Examples of barriers | Examples of facilitators |
---|---|---|
Theme 1: Awareness of palliative care | ||
 Awareness, knowledge, education or experience among health care professionals | Lacking understanding of the broad applicability of PC among HPs [51]. | Improving education on PC for HPs in general, including experiencing observation and receiving support [39]. |
 Awareness among patients and families | Patient and families do not know the purpose of PC involvement [64]. | Increase of opportunities of patient education on PC for instance videos [64]. |
Theme 2: Collaboration and communication in health care settings | ||
 Collaboration and communication between health care professionals and patients and their families | Health care professionals’ difficulty in communicating patients’ prognoses [54]. | The use of short assessment scales, communication note-books and medical files with non-physical information [23]. |
 Collaboration and communication between health care professionals | Difficulty in dealing with conflicting information about the goals of care which are them given among nurses [26]. | PC team strategic visibility in patient floors and hospital-wide events and PC team unintentional visibility like being present around the hospital [64]. |
Theme 3: Emotions involved in disease paths | ||
 Emotions among health care professionals | Barriers to discuss PC: emotional bond, emotional discomfort among oncologists [34]. | Further education and training focused on dealing properly with patient psychosocial and emotional problems for HPs [52]. |
 Emotions among patients and their families | Emotions in patients such as sadness/suppression, unrealistic expectations, infinite trust and faith in medicine, giving up hope, overly optimistic about life expectation [34]. | Assessing psychological condition and treating mental disorders of patient [65]. |
Theme 4: Attitudes and beliefs towards palliative care | ||
 Attitudes and beliefs among health care professionals | Belief that PC is not appropriate for those who have complex problems without physical symptoms among HPs [38]. | Provision of clear, convincing, scientific support, concerning palliative care, for recommendations from the PC team [64]. |
 Attitudes and beliefs among patients and their families | Interpretation of earlier and broader PC consultations as a cost saving measure (rather than clinically beneficial measure) among patients and their families [58]. | Renaming ‘palliative care’ to ‘supportive care’, as patients were more receptive to the second name [57]. |