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When to Refer Patients to Palliative Care: Triggers, Traps, and Timely Referrals

Melvin, Christina S. MS, PHCNS, BC; Oldham, Lynn PhD, BN (Hons), RN

Journal of Hospice & Palliative Nursing: September-October 2009 - Volume 11 - Issue 5 - p 291-301
doi: 10.1097/NJH.0b013e3181b543d4
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This article examines the issue of late referral or nonreferral to palliative care for people with a life-limiting disease/illness. The primary purpose of the study was to examine barriers to timely referral to palliative care. The secondary purpose was to explore the impact of late referral on quality of life for palliative care patients and families (reported separately). The authors used a phenomenological research design. Current literature provides clear evidence that the needs of dying people are unique and require specialized care. Qualitative interviews were conducted with 11 palliative care health professionals. Interviews were tape recorded, transcribed, and content analyzed. In this article, findings are reported from healthcare providers' perspectives and include medical practitioners and nurses from several sites in Perth, Western Australia. Lack of knowledge about palliative care services and its benefits was the overarching theme among all three groups (healthcare providers, patients, and families).

Author Affiliations: Christina S. Melvin, MS, PHCNS, BC, is Clinical Assistant Professor, Department of Nursing, University of Vermont, Burlington.

Lynn Oldham, PhD, BN (Hons), RN, is Associate Professor and Deputy Director, WA Centre for Cancer and Palliative Care, Curtin University of Technology, Health Research Campus, Perth, Western Australia.

Address correspondence to Christina S. Melvin, MS, PHCNS, BC, Department of Nursing, University of Vermont, 213 Rowell Bldg, 106 Carrigan Dr, Burlington, VT 05405-0068 (Christina.Melvin@uvm.edu).

© 2009 The Hospice and Palliative Nurses Association