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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

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].