Table 1.

Interview guide.

Topic	Question	Prompts, as needed
PREAMABLE: Thank-you for giving up your time today to attend this focus group/interview. You may recall the purpose of the session is to discuss issues pertinent to the introduction of early palliative care for patients with advanced cancer and their families.
Topic 1: Discussion of past cases when the clinician has referred a person for early palliative care	To begin, can you reflect back upon a previous patient that you have referred to early palliative care. Please discuss this case and share some of the circumstances leading up to this referral, the discussion that took place, and how this was received.	What prompted the referral/conversation? How was the referral/conversation received? How did the patient and their family respond? Did you feel it was appropriate timing? If so/why? Why not earlier? Why not later?
Topic 2: Views of the timing of palliative care referral early in the illness	Now I would like to discuss how you see early palliative care fitting into the overall management and support offered for patients with advanced cancer. How would you define the timing of ‘early’ palliative care?	What are the key needs and concerns at the time of introduction to early palliative care? - For patients? - For families? - For you as a health care provider? At what time in the person’s illness might you consider referring to early palliative care? What prompts you to think you should get palliative care involved early on?
Topic 3: Communication about early palliative care	I wonder now, if we can discuss, how you might go about talking about early palliative care with patients and their families once you’ve you identified they may benefit from it. Given some of the complexities of talking about early palliative care, how might you explain this to patients and their families?	What might you say? What works well? What doesn’t work so well? What strategies do you use to introduce early palliative care? What is difficult about this discussion?
Topic 4: Barriers and enablers relating early palliative care referral.	Lastly I would like to discuss your views of the barriers and enablers associated with referral to early palliative care. When you see a role for early palliative care, what do you see to be the key inhibiting and enabling factors in raising this?	Patient understanding of palliative care? ▪ If so/what do they understand Patient hopes Communication Time Relationships Others?