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Table 1 Themes of perceived cognitive barriers and facilitators to palliative care use

From: Palliative care utilization in oncology and hemato-oncology: a systematic review of cognitive barriers and facilitators from the perspective of healthcare professionals, adult patients, and their families

ThemesExamples of barriersExamples of facilitators
Theme 1: Awareness of palliative care
 Awareness, knowledge, education or experience among health care professionalsLacking 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 familiesPatient 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 familiesHealth 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 professionalsDifficulty 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 professionalsBarriers 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 familiesEmotions 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 professionalsBelief 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 familiesInterpretation 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].