Early Palliative Care Team's Perception of Relational Work for Advanced Cancer Patients: A Qualitative Study

Le résumé fourni par la source

BACKGROUND: In a day hospital stay, the palliative care (PC) delivery includes multi-disciplinary assessment of palliative care (PC) needs, with treating oncologist and supportive care professionals with a long time allocated for discussions with the patients and family. But little is known about the specificity of the relational work delivered by the PC team. AIMS: The aim of this study was to explore the nature of the relational work carried out at the PC day hospital from the perspective of the PC team. METHODS: This qualitative research used semi-structured open-ended interviews, conducted and analysed according to grounded theory. Twelve physicians and twelve nurses from PC team were interviewed over a period of 5 months to collect clinical cases. RESULTS: The analysis resulted in three main categories that explain the processes of relational work during PC Day Hospital sessions: (1) Patient engagement is necessary to increase relational work and gain patients' confidence. This involves initiating medical exchanges from the patient's point of view to obtain their participation; (2) Raising awareness of irreversible decline and approaching death using interactive relational work tactics, in line with oncologists when making decisions and announcing the discontinuation of cancer treatment; (3) Managing the final phase of the cancer trajectory requires negotiating home care terms and being aware of the family's influence. CONCLUSIONS: PC day hospital in cancer centres allows a pluri-professional relational work including the oncologists which facilitates serious illness conversation, advance care planning and end-of-life care management for advanced cancer patients.

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