Table 2.
Characteristics of the selected studies
| *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 |