Table 2.

Themes and Representative Quotes

Themes	Representative quotes
Theme 1: Lack of a verbatim interpretation for the term “PALLIATIVE CARE”	“We don't have that part of medicine in our country, so we don't have anything in our country close to it. But we just interpret it the best way we can. We just tell them exactly as I told you, this department is for patients when there is no more treatment, and it can take care of your quality of life” “There are at least three, if not more than three ways [palliative care] translate to. It all depends on how much you want to focus on the issue of death.”
Theme 2: Poor patient understanding of their treatment goals	“Sometimes they just get so angry and so frustrated and a lot of times they're like, ‘why didn't anyone tell me this sooner?’ I get that a lot of times it's because the kids or the wife didn't tell him he's dying”
Theme 3: Suboptimal timing of palliative care involvement	“I think once the person knows that they have cancer or a terminal issue, right away palliative care should be approached just to say, ‘we're an option. Reach out to us if you need us. This is what we can provide for you.’ But if the guy is already dying and you offer palliative care, he just looks at you and he's like ‘where were you three months ago?’”
Theme 4: Fears and misconceptions related to palliative care	“When we say ‘since you are gravely ill, we should involve palliative care.’ For Russians, this doesn't go well, it's like you are saying there's no hope for you, but they want to always have hope. And that's why palliative is a bad word for them. Let me first say, they are scared of the word. They want to have hope until the last day they breathe. It's like taking the hope away for them.”