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The Perceived Facilitators and Challenges of Translating a Lung Cancer Palliative Care Intervention Into Community-Based Settings

Siler, Shaunna, PhD, RN; Mamier, Iris, PhD, RN; Winslow, Betty, PhD, RN

Journal of Hospice & Palliative Nursing: August 2018 - Volume 20 - Issue 4 - p 407–415
doi: 10.1097/NJH.0000000000000470
Feature Articles

Despite significant progress in implementing palliative care interventions for patients with cancer, few intervention studies seek health care clinicians’ input before implementation of these into the community. The purpose of this study was to explore palliative care and oncology clinicians’ perspectives on the perceived facilitators and challenges in meeting the quality-of-life needs of patients with lung cancer and family caregivers in community-based settings. The Reach Effectiveness Adoption Implementation Maintenance model for implementation research was used as a framework. This was a multisite qualitative study using focus group and key informant interviews. Nineteen clinicians addressed useful practices and challenges in the following areas: (a) early palliative care, (b) interdisciplinary care planning, (c) symptom management, (d) addressing psychological and social needs, and (e) providing culturally respectful care, including spiritual care. In preparation for the intervention, specific education needs and organizational challenges were revealed. Challenges included timing and staffing constraints, the need for clinician education on palliative care services to increase organizational buy-in, and education in providing spiritual support for patients and family caregivers. This research allowed investigators to understand perceptions of clinicians as they prepared to integrate palliative care in their settings. Hospice and palliative care nurses can be instrumental in implementing palliative care into community practice.

Shaunna Siler, PhD, RN, is assistant professor, School of Nursing, Loma Linda University, CA.

Iris Mamier, PhD, RN, is associate professor, School of Nursing, Loma Linda University, CA.

Betty Winslow, PhD, RN, is professor emerita, School of Nursing, Loma Linda University, CA.

Address correspondence to Shaunna Siler, PhD, RN, Undergraduate Program, School of Nursing, Loma Linda University, 11262 Campus St, West Hall, Loma Linda, CA 92350 (

This research study was funded by a National Institute of Nursing Research Diversity Supplement Award to promote diversity in health-related research (grant number 3R01NR015341-02W1; PI name: Betty R. Ferrell).

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.