Scientific article JUN 2020
Professionals' experiences with palliative care and collaboration in relation to a randomised clinical trial: a qualitative interview study
Authors:
- Mette Raunkjær
- Martin Sandberg Buch
- Christina Holm-Petersen
- Helle Ussing Timm

Background
International evidence on the outcome of generalist versus specialist palliative care provision in palliative care trajectories is limited and varied. In general, intervention studies can influence the organisation of palliative care practice and professional collaborations. However, randomised clinical trials in palliative care rarely consider the organisational significance of the studies, as experienced by the professionals involved. DOMUS is the abbreviation for a Danish intervention study designed as a randomised clinical trial, investigating an accelerated transition from oncological to specialist palliative care at home for patients with incurable cancer. Alongside conducting the palliative care intervention study, we wanted to discover the perspectives of the healthcare professionals involved.
Aim
To explore the organisational significance of the DOMUS intervention study as experienced by the professionals involved.
Design
A qualitative interview study, using thematic content analysis and inspired by organisational theory.
Setting/participants
Thirty‐eight professionals from four units involved in the DOMUS intervention study took part in 10 groups and six individual interviews.
Results
The DOMUS randomised clinical trial intervention influenced and sometimes disrupted both the ways of organising, collaborating and practising palliative care, and patients’ and relatives’ understanding of their own situation. It did this by (1) referring a broader palliative care target group to specialist palliative care, leading to (2) different palliative care needs, professional tasks, and perceived impact on (3) the organisation of palliative care and (4) professional collaboration.
Conclusion
Professionals involved in the DOMUS palliative care intervention found that the study had organisational significance, with an influence on professionals, patients and relatives. Specialist palliative care in Denmark is devoted organisationally and professionally to patients with severe or complex palliative care needs. Hence, new ways of organising palliative care for people in the earlier stages of their disease are needed.
International evidence on the outcome of generalist versus specialist palliative care provision in palliative care trajectories is limited and varied. In general, intervention studies can influence the organisation of palliative care practice and professional collaborations. However, randomised clinical trials in palliative care rarely consider the organisational significance of the studies, as experienced by the professionals involved. DOMUS is the abbreviation for a Danish intervention study designed as a randomised clinical trial, investigating an accelerated transition from oncological to specialist palliative care at home for patients with incurable cancer. Alongside conducting the palliative care intervention study, we wanted to discover the perspectives of the healthcare professionals involved.
Aim
To explore the organisational significance of the DOMUS intervention study as experienced by the professionals involved.
Design
A qualitative interview study, using thematic content analysis and inspired by organisational theory.
Setting/participants
Thirty‐eight professionals from four units involved in the DOMUS intervention study took part in 10 groups and six individual interviews.
Results
The DOMUS randomised clinical trial intervention influenced and sometimes disrupted both the ways of organising, collaborating and practising palliative care, and patients’ and relatives’ understanding of their own situation. It did this by (1) referring a broader palliative care target group to specialist palliative care, leading to (2) different palliative care needs, professional tasks, and perceived impact on (3) the organisation of palliative care and (4) professional collaboration.
Conclusion
Professionals involved in the DOMUS palliative care intervention found that the study had organisational significance, with an influence on professionals, patients and relatives. Specialist palliative care in Denmark is devoted organisationally and professionally to patients with severe or complex palliative care needs. Hence, new ways of organising palliative care for people in the earlier stages of their disease are needed.
Authors
About this publication
Financed by
TrygFonden og Kræftens bekæmpelseCollaborators
REHPA, Videncenter for Rehabilitering og PalliationPublished in
Scandinavian Journal of Caring Sciences