Hematology nurses’ perceptions of implementing primary palliative care for patients with multiple myeloma: A qualitative study

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PURPOSE: Current palliative care (PC) often relies on specialist consultation. This study focuses on a newer model: integrative PC (primary PC), delivered by regular staff (specifically hematology nurses) who are trained to deliver basic palliative interventions alongside routine clinical care. While established in solid tumors, PC integration lags in hematology. The aim is to describe the hematology nurses' perceptions and experiences providing this integrative PC model to patients with Multiple Myeloma (MM). METHODS: A qualitative exploratory study was conducted using a phenomenological-hermeneutic approach. Ten hematology nurses who participated in the implementation were purposively selected and interviewed individually through semi-structured, in-depth interviews conducted by a female nurse researcher experienced in qualitative methods six months after the implementation of an integrative palliative care model. Thematic analysis was applied to identify key patterns and meanings in the data. RESULTS: Three main themes emerged: (1) Becoming a Therapeutic Anchor, (2) Transforming the Role from Clinical Technician to Holistic Caregiver, and (3) Bridging Systemic Gaps as the Care Coordinator. Nurses described enhanced relationships with patients, earlier symptom detection, culturally responsive holistic care, and greater involvement in emotional support and care coordination. They also highlighted the emotional burden of sustaining such care and emphasized the need for institutional support. CONCLUSION: The findings suggest that hematology nurses may play a significant role in implementing integrative PC for patients with MM. Their involvement enhances holistic care and symptom management. However, sustaining this model requires attention to the emotional demands on nurses and the need for institutional support.

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