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Table 2 Characteristics of the selected studies

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

*Study no.

Author/s and year

Aim

Design

Participants and origin

Data collection method

1

Akiyama, M., Takebayashi, T., et al., 2012 [20]

To assess patients’ knowledge, beliefs, or concerns about opioids, palliative care (PC), and homecare

Quantitative – Survey study

925 outpatients with metastatic or recurrent cancer - Japan

Questionnaire (mail paper form)

2

Alaeddini, J., Julliard, K., et al., 2000 [21]

To explore physicians’ attitudes and opinions about PC and its implementation

Qualitative

23 physicians (community primary care physicians, hospital-based ambulatory clinic physicians, and specialists) - USA

Focus-group

3

Ansari, M., Rassouli, M.,et al., 2018 [22]

To explore the educational needs of stakeholders of palliative care for cancer patients

Qualitative

20 participants: cancer patients

and their caregivers; healthcare

providers, experts and policy-makers active in the field of cancer - Iran

Semi-structured interview

4

Beernaert, K., Deliens, L., et al., 2014 [23]

To examine barriers and facilitators of the early identification of PC needs by family physicians (FP)

Qualitative

20 FP, 12 community and PC

nurses, 18 patients - Belgium

Focus-group and semi-structured interview

5

Boyd, D., Merkh, K., et al., 2011 [24]

To identify oncology nurses’ attitudes toward care at the end of life and PC use

Quantitative – Cross-sectional, descriptive correlational survey study

31 oncology nurses - USA

Questionnaire

6

Bradley, E. H., Cramer, L. D., et al., 2002 [89]

To identify physicians’ characteristics associated to referral to PC

Quantitative - Cross-sectional study

231 physicians (internists, family physicians, oncologists, pulmonologists, and cardiologists) - USA

Questionnaire

7

Broom, A., Kirby, E. et al., 2012 [25]

To examine the logics underpinning the timing of referral to PC

Qualitative

20 medical specialists (oncology, urology, haematology, geriatrics, general medicine, nonspecialist palliative medicine) - Australia

Semi-structured interview

8

Canzona, M. R., Love, D., et al., 2018 [26]

To investigate challenges that nurses face when they provide care for oncological patients transitioning from curative to palliative care and to identify educational opportunities for nurses

Qualitative Mixed

28 nurses (14 practicing in oncology and 14 practicing in palliative care) - USA

Semi-structured interview (telephone)

9

Cherny, N. I. and Catane, R., 2003 [27]

To identify oncologist-related barriers to the provision of optimal supportive and PC

Quantitative – Cross-sectional survey study

895 oncologists (members of the European Society of Medical Oncology) – Europe (82.5%), America (12.1%), Australia (2.2%), Asia (2.6%) and Africa (0.7%).

Questionnaire

10

Feeg, V. D. and Elebiary, H., 2005 [28]

To explore professionals’ perceptions about barriers related to hospice and PC, opinions about barriers related to dying at home, and barriers related to advance directives

Quantitative – Cross-sectional survey

100 national conference on PC attendees (nurses 71%, social workers 11%, hospital/hospice administrators 6%, physicians 4%, counselors 3%, chaplains 3%, and physical therapists 2%) - USA

Questionnaire

11

Fox, J., Windsor, C. et al., 2016 [29]

To explore the transition to PC

Qualitative

29 participants:

patients, family carers, and healthcare professionals - Australia

Semi-structured interview

12

Gidwani, R., Nevedal, A., et al., 2017 [30]

To characterize oncologists’ perceptions of primary and specialist PC; experiences interacting with PC specialists; and the optimal interface of PC and oncology in providing PC

Qualitative

31 oncologists -USA

Semi-structured interview (telephone)

13

Gott, M., Ingleton, C. et al., 2011 [31]

To explore how transitions to a PC

approach are perceived to be managed in acute hospital settings

Qualitative

58 health professionals (involved in the

provision of PC) – United Kingdom

Focus group and interview

14

Groot, M. M., Vernooij-Dassen, M. J. et al., 2005 [32]

To investigate general practitioners’ task perception and barriers involved in PC

Qualitative

12–33 general practitioners (non specified the exact number) – The Netherlands

Focus-group

15

Miyashita, M., Hirai, K. et al., 2008 [33]

To investigate the barriers to referral to inpatient PC units

Qualitative

63 participants (13 advanced cancer patients, 10 family members, 20 physicians, and 20 nurses in PC and acute care cancer settings) - Japan

Semi-structured interview

16

Horlait, M., Chambaere, K. et al., 2016 [34]

To identify the barriers that oncologists experience to introduce PC to patients

Qualitative

15 oncologists Belgium

Semi-structured interview

17

Hui, D., Cerana, M. A. et al., 2016 [35]

To examine the association between oncologists’ end of life care attitudes and timely specialist PC referral

Quantitative – Cross-sectional

240 oncology specialists (120 hematologic and 120 solid oncology specialists) – USA

Questionnaire

18

Hui, D., Park, M. et al., 2015 [37]

To examine the differences in attitudes and beliefs toward PC referral

between hematologic and solid tumor specialists

Quantitative - Cross-sectional

240 oncology specialists (120 hematologic and 120 solid oncology specialists) – USA

Questionnaire

19

Johnson, C., Paul, C. et al., 2011 [74]

To explore doctors’ perceptions of barriers to referring patients for specialized PC.

Qualitative – Exploratory study

40 medical doctors (general practitioners, oncologists, radiation oncologists, hematologists, respiratory physicians and colorectal surgeons) - Australia

Interview (telephone)

20

Kafadar, D., Ince, N. et al., 2015 [38]

To evaluate the managerial perspectives and opinions about specialized PC

Mixed method

70 medical directors - Turkey

Questionnaire

21

Kawaguchi, S., Mirza, R. et al., 2017 [39]

To explore medical doctors’ understanding of and experiences with PC

Qualitative

10 internal medicine residents - Canada

Semi-structured interview

22

Keim-Malpass, J., Mitchell, E. M. et al., 2015 [40]

To identify existing barriers in accessing PC services for cancer patients

Qualitative

42 clinicians, administrative support staff, and service support personnel - USA

Semi-structured interview

23

Kirby, E., Broom, A. et al., 2014 [41]

To examine how medical specialist conduct the process of negotiation of the transition to specialist PC with families

Qualitative

20 medical specialists (e.g. medical oncology, haematology, surgery, radiation oncology, general medicine, geriatrics, etc.) Australia

Semi-structured interview

24

Kumar, P., Casarett, D. et al., 2012 [42]

To identify barriers to supportive and PC services among oncology outpatients

Quantitative - Cross-sectional

313 patients with breast, lung or gastrointestinal cancer - USA

Questionnaire

25

Le, B. H., Mileshkin, C., L. et al., 2014 [77]

To explore lung cancer clinicians’ perceptions of PC and to identify views, barriers and benefits of referring to PC

Qualitative

28 clinicians (involved in the management of patients with lung cancer) - Australia

Focus group and semi-structured interview

26

Le, B. H. C. and Watt, J. N., 2010d [43]

To assess care provided to patients dying and to understand

senior clinician decision-making around referral to PC

Mixed method

27 (senior) clinicians - Australia

A retrospective chart-audit and semi structured interview

27

LeBlanc, T. W., O’Donnell, J. D. et al., 2015 [44]

To examine perceptions of PC among hematologic and solid tumor oncologists

Mixed method

66 oncologists:

23 treating hematologic malignancies and 43 treating solid tumors - USA

Semi-structured interview and questionnaire

28

Llamas, K. J., Llamas, M. et al., 2001 [45]

To identify PC service needs, and educational and support

needs of hospital teaching staff

Quantitative - Cross-sectional

267 multi-disciplinary oncology staff (medical, nursing, radiation therapy and other disciplines) - Australia

Questionnaire

29

Mahon, M. M. and McAuley, W. J., 2010 [46]

To examine nurses’ points of views and beliefs about PC and PC decision making

Qualitative

12 oncology nursing - USA

Interview

30

McDarby, M. and Carpenter, B. D., 2019 [64]

To identify factors that impede or facilitate the palliative care consultation team’s successful collaboration with other health care professionals

Qualitative

48 providers (19 palliative care providers, 29 nonpalliative care providers) - USA

Interview (telephone and site)

31

McGrath, P., 2013 [47]

To explore issues associated with the experience of survivorship for hematology patients

Qualitative

50 oncology patients (Multiple Myeloma, Lymphoma, Leukemia and Other) - Australia

Open-ended interview and focus group

32

McIlfatrick, S., 2007 [48]

To assess the PC needs from the perspectives of patients, informal carers and healthcare providers

Mixed method

76 patients and lay carers receiving PC services – United Kingdom

Semi-structured interview and focus-group

33

Melvin, C. S., 2010 [49]

To examine obstacles to timely referral to PC services and to explore the impact of late referral on quality of life

Qualitative

13 patients

6 family members - Australia

Interview

34

Mohammed, S., Swami, N., 2018 [50]

To examine bereaved caregivers’ experiences of providing care at home for patients with advanced cancer, while interacting with home care services

Qualitative

61 bereaved caregivers (30 intervention, 31 control) - Canada

Semi-structured interview

35

Monterosso, L., Ross-Adjie, G. M. et al., 2016 [51]

To identify HPs’ perspectives, education, and support needs related to PC provision

Mixed method

302 multi-disciplinary health professionals - Australia

Focus group

36

Norton, S. A., Wittink, M. N., et al., 2019 [72]

To explore family caregivers’ points of view of the final month of life of patients with advanced cancer

Qualitative

92 family caregivers of patients with end-stage cancer - USA

Semi-structured interview

37

O’Connor, M. and Lee-Steere, R., 2006 [52]

To explore general practitioners’ attitudes to PC in a rural center, in particular the perceived barriers to the provision of PC

Qualitative

10 general practitioners - Australia

Interview

38

Odejide, D. Y. Salas Coronado, et al., 2014 [53]

To explore hematologic oncologists’ perspectives and decision-making processes regarding end-of-life care

Qualitative

20 hematologic oncologists - USA

Focus group

39

Patel, M. I., Periyakoil, V. S., 2018 [54]

To examine clinical providers’ experiences delivering cancer care for patients at the end of life and their thoughts on potential solutions to improve quality of care

Qualitative

75 cancer care providers (35 physicians, 20 nursing staff, 12 social workers, and 8 patient navigators) - USA

Semi-structured interview

40

Philip, J. A. M. and Komesaroff, P., 2006 [55]

To explore the concept of ideal PC and the barriers to the access

Qualitative

45 PC professionals from community, inpatient, and hospital consultancy services - Australia

Focus group

41

Redman, S., White, K. et al., 1995 [90]

To examine PC nurses’ professional need and clinical knowledge

Quantitative - Cross-sectional

108 nurses - Australia

Questionnaire and interview

42

Rhee, J. J.-O., Zwar, N. et al., 2008 [56]

To establish the level of participation of urban general practitioners and to identify the barriers which they have to face in palliative care provision

Quantitative - Cross-sectional

269 general practitioners - Australia

Questionnaire

43

Rhondali, W., Burt, S. et al., 2013 [57]

To explore the oncologists’ perceptions of a supportive care program, and to determine whether renaming ‘palliative care’ influenced communication regarding referrals

Qualitative

17 oncologists - USA

Semi-structured interview

44

Rodriguez, K. L., Barnato, A. E. et al., 2007 [58]

To explore the perceptions of PC and to identify barriers to earlier use of PC in the illness trajectory

Qualitative

120 health care providers (on intensive care unit) - USA

Semi-structured interview

45

Ronaldson, S. and Devery, K., 2001 [59]

To investigate the transition to palliative care services

Qualitative

11 inpatients and 5 nursing staff members - Australia

Semi-structured interview

46

Rugno, C. P., Rebeiro Paiva, B. S. et al., 2014 [60]

To explore women’s understanding on the reasons anticancer treatment withdrawal, their thoughts about palliative care, and also prospective on the communication of bad news

Qualitative

22 women with advanced cancer (14 breast, 4 cervical, 1 ovarian, and 1 endometrial cancer) - Brazil

Semi-structured interview

47

Sanjo, M., Morita, T., 2018 [61]

To explore experiences of family members of patients with cancer receiving information concerning palliative care unit consultations

Quantitative - Survey

465 family member of adult patients with cancer - Japan

Questionnaire (mail paper form)

48

Schenker, Y., Crowley-Matoka, M. et al., 2014 [62]

To examine oncologist factors that influence referrals to outpatient specialized PC

Qualitative

74 medical oncologists - USA

Interview

49

Smith, C. B., Nelson, J. E. et al., 2012 [79]

To ascertain factors influencing physicians decisions for referral to PC

Quantitative - Cross-sectional

155 physicians (caring for cancer patients) - USA

Self-administered questionnaire

50

Walshe, C., Chew-Graham, C. et al., 2008 [91]

To examine the influences on referral decisions made

(within community PC services)

Qualitative

57 healthcare professionals interviewed;

13 case notes;

84 other non-patient documents – United Kingdom

Interview, observation and documentary analysis

51

Ward, A. M., Agar, M. et al., 2009 [63]

To explore attitudes of medical oncologists toward collaboration with specialist PC services

Mixed method

78 medical oncologists and 37 trainees – Australia

Questionnaire (web-based)

52

Zhang, Z. and Cheng, W.W., 2014 [65]

To explore the process to access and role of PC

Qualitative

1 patient (doctor) – China

Observation