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Coordination of palliative cancer care in the community: “unfinished business”

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Abstract

Goal

This study assessed the degree to which services in south–central Ontario, Canada, were coordinated to meet the supportive care needs of palliative cancer patients and their families.

Participants and method

Programs within the region that were identified as providing supportive care to palliative cancer patients and their families were eligible to participate in the study. Program administrators participated in a semi-structured interview and direct-care providers completed a survey instrument.

Main results

Administrators from 37 (97%) of 38 eligible programs and 109 direct-care providers representing 26 (70%) programs participated in the study. Most administrator and direct-care respondents felt that existing services in the community were responsive to palliative care patients’ individual needs. However, at a system level, most respondents in both groups felt that required services were not available and that resources were inadequate. The most frequently reported unmet supportive care need identified by both respondent groups was psychological/social support. Most administrator (69%) and direct-care (64%) respondents felt that palliative care services were not available when needed. The majority of administrator and direct-care respondents were satisfied with the exchange of patient information within and between programs, although direct-care staff identified a deficit in information transferred on palliative care patients’ social/psychological status.

Conclusions

The study demonstrated the value of a theory-based approach to evaluate the coordination of palliative cancer care services. The findings revealed that service programs faced significant challenges in their efforts to provide coordinated care.

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Authors and Affiliations

  1. St. Joseph’s Health System Research Network; Supportive Care Research Unit, Juravinski Cancer Center; Department of Clinical Epidemiology and Biostatistics, McMaster University, 105 Main St E., Level P1, Hamilton, Ontario, Canada, L8N 1G6

    Kevin Brazil

  2. Supportive Cancer Care Research Unit, Juravinski Cancer Center, Hamilton, Ontario, Canada

    Daryl Bainbridge & Nancy Pyette

  3. Supportive Cancer Care Research Unit, Juravinski Cancer Center; Department of Medicine, McMaster University, Hamilton, Ontario, Canada

    Jonathan Sussman & Tim Whelan

  4. Supportive Cancer Care Research Unit, Juravinski Cancer Centre; School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada

    Mary Ann O’Brien

Authors
  1. Kevin Brazil
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  2. Daryl Bainbridge
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  3. Jonathan Sussman
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  4. Tim Whelan
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  5. Mary Ann O’Brien
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  6. Nancy Pyette
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Corresponding author

Correspondence to Kevin Brazil.

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Brazil, K., Bainbridge, D., Sussman, J. et al. Coordination of palliative cancer care in the community: “unfinished business”. Support Care Cancer 17, 819–828 (2009). https://doi.org/10.1007/s00520-009-0582-x

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  • DOI: https://doi.org/10.1007/s00520-009-0582-x

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