Family Physicians' Perspectives on Their Role in Palliative Care: A Double Focus Group in Portugal.

Carlos Seiça Cardoso,Beatriz Xavier,Filipe Prazeres,Bárbara Gomes

doi:10.3390/ijerph18147282

Abstract

Background: Aggravated by the COVID-19 pandemic, the provision of palliative care for patients with palliative care needs emerges as a necessity more than ever. Most are managed in primary care by their family physicians (FP). This study aimed to understand the perspectives of specialist and trainee FPs about their role in palliative care. Methods: we conducted a double focus-group study consisting of two separate online focus-groups, one with FP specialists (n = 9) and one with FP trainees (n = 10). Results: FPs already gather two fundamental skills for the provision of palliative care: the capacity to identify patients’ needs beyond physical symptoms and the recognition that the patient belongs to a familiar, psychosocial, and even spiritual environment. They perceive their role in palliative care to be four-fold: early identification of patients with palliative care needs, initial treatment, symptom management, and patient advocacy. Participants recognized the need for palliative care training and provided suggestions for training programs. Conclusion: FPs share a holistic approach and identify multiple roles they can play in palliative care, from screening to care and advocacy. Organizational barriers must be addressed. Short training programs that combine theory, practice, and experiential learning may further the potential for FPs to contribute to palliative care.

Highlights

In the last decades, the number of people living with chronic diseases has increased, mainly due to population aging, leading to an increase in dependency status and entailing important social costs [1]
Most patients with chronic illness are managed in primary care over a long period of time [5] and their family physicians (FP), can play an important role in the palliative care (PC) network; some existing evidence shows that when an FP is involved, the provision of PC seems to improve, with benefits for both patients and their families [6,7]
It is known that most patients with chronic illness are managed in primary care over a long period of time, and that when the FP is involved, the provision of PC seems to improve, with benefits for both patients and their families [6,7], but it is important to understand what clinicians think and how clinicians deal with palliative care in their daily clinical practice

Summary

Introduction

The number of people living with chronic diseases has increased, mainly due to population aging, leading to an increase in dependency status and entailing important social costs [1] These chronic, progressive, life-threatening, and burdening diseases play an important role in this new era of the palliative care (PC) approach. Results: FPs already gather two fundamental skills for the provision of palliative care: the capacity to identify patients’ needs beyond physical symptoms and the recognition that the patient belongs to a familiar, psychosocial, and even spiritual environment. They perceive their role in palliative care to be four-fold: early identification of patients with palliative care needs, initial treatment, symptom management, and patient advocacy. Short training programs that combine theory, practice, and experiential learning may further the potential for FPs to contribute to palliative care

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Discussion

Conclusion