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As a part of the \u2018Difficult Discussions\u2019 study, focused on palliative care and advance care planning discussions with AYAs with cancer, we investigated the factors that healthcare professionals identify as barriers and facilitators to end\u2010of\u2010life conversations. Twenty\u2010eight multidisciplinary healthcare professionals participated in semi\u2010structured interviews exploring conversations focused on end\u2010of\u2010life care (29% oncologists\/haematologists, 39% nurses and 32% allied health professionals). Data were analysed through qualitative content analysis using an inductive approach. The conversations were shaped by factors at the healthcare professionals\u2019 personal, interpersonal, teams and hospital system levels, as well as being influenced by cultural and societal influences. Barriers at each level included patients\u2019 and caregivers\u2019 emotional needs; patients\u2019 maturity levels; lack of relational trust between patient, caregiver and healthcare professional; and the social taboo of speaking about death with young people. Conversely, good communication between members of the multidisciplinary team was identified as a facilitator, as working effectively in a team was found to mitigate some of the emotional burden and logistical constraints of conducting end\u2010of\u2010life conversations. The results of this study offer new insights into how the interplay of these factors acts as facilitators and barriers to communication. Further research could explore the communication processes that facilitate trust between the AYA and healthcare team, factors associated with AYAs\u2019 readiness and the optimal time to conduct end\u2010of\u2010life conversations.<\/jats:p>","DOI":"10.1002\/1545-5017.70369","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:46:36Z","timestamp":1778154396000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["\u2018They Need to Hear You Say It\u2019: Healthcare Professionals\u2019 Perspectives on Barriers and Enablers to End\u2010of\u2010Life Discussions With Adolescents and Young Adults With Cancer"],"prefix":"10.1002","volume":"73","author":[{"given":"Justine","family":"Lee","sequence":"first","affiliation":[{"name":"Behavioural Sciences Unit School of Clinical Medicine UNSW Medicine and Health, Discipline of Paediatrics and Child Health, Randwick Clinical Campus, UNSW Sydney  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Randwick Clinical Campus, UNSW Sydney  Sydney Australia"},{"name":"Kids Cancer Centre Sydney Children's Hospital  Randwick New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Lobb","sequence":"additional","affiliation":[{"name":"Improving Palliative Aged and Chronic Care Through Clinical Research and Translation (IMPACCT) Faculty of Health University of Technology  Ultimo New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori","family":"Wiener","sequence":"additional","affiliation":[{"name":"Center for Cancer Research National Cancer Institute, National Institutes of Health  Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5500-4330","authenticated-orcid":false,"given":"Madeleine L.","family":"Juhrmann","sequence":"additional","affiliation":[{"name":"Behavioural Sciences Unit School of Clinical Medicine UNSW 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