{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:06:21Z","timestamp":1766390781054,"version":"3.48.0"},"reference-count":35,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Pall Supp Care"],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S147895152510120X_sec1a\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Patients with advanced cancer, their caregivers, and healthcare professionals can differ in their preferences for patient treatment and care. The objectives of this study were to (1) identify what healthcare professionals in specialist palliative care feel aids or challenges patients with advanced cancer and their caregivers to manage their discordance, and (2) decipher what is helpful or challenging for healthcare professionals themselves to manage discordance between patients with advanced cancer and their caregivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152510120X_sec2b\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative study was conducted comprising online focus groups with 19 healthcare professionals from different professions in specialist palliative care. Participants were purposively and snowball sampled, and recruited from specialist palliative care settings, including hospital, hospice, and community-based care. The data were member checked and analyzed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152510120X_sec3c\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Trust and consistent communication between the patient, caregiver, and healthcare professional, were considered by participants as helpful for patients and caregivers to manage discordance. Emotional and psychological burden for both the patient and caregiver together with preexisting conflict between the patient and caregiver, were perceived as barriers for patients and caregivers to manage their discordance. Knowledge and expertise gained from practice combined with professional resilience and peer support enabled participants to help patients and caregivers navigate discordance. Relational conflict between the patient and caregiver combined with participants\u2019 own uncertainty about ethical and legal connotations of helping the patient and caregiver resolve their differences, were barriers to helping the patient and caregiver manage their discordance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S147895152510120X_sec4d\">\n                    <jats:title>Significance of results<\/jats:title>\n                    <jats:p>Interventions focused on assisting patients with advanced cancer in palliative care and their caregivers manage their differences in decision-making could serve to alleviate emotional burden for both the patient and caregiver. Healthcare professionals in specialist palliative care value the perspective of both patients with advanced cancer and their caregivers when helping them manage their discordance in decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s147895152510120x","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T08:01:12Z","timestamp":1766390472000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Discordance in decision-making between patients with advanced cancer and caregivers from the perspective of healthcare professionals in specialist palliative care: A focus group study"],"prefix":"10.1017","volume":"24","author":[{"given":"Joshua","family":"Hernon","sequence":"first","affiliation":[{"name":"Trinity College Dublin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Lombard","sequence":"additional","affiliation":[{"name":"University of Limerick"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-7590","authenticated-orcid":false,"given":"Suzanne","family":"Guerin","sequence":"additional","affiliation":[{"name":"University College Dublin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Featherstone","sequence":"additional","affiliation":[{"name":"Our Lady of Lourdes Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norma","family":"O'Leary","sequence":"additional","affiliation":[{"name":"Our Lady\u2019s Hospice and Care Services"},{"name":"St. James\u2019s Hospital"},{"name":"Trinity College Dublin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7952-9246","authenticated-orcid":false,"given":"Geraldine","family":"Foley","sequence":"additional","affiliation":[{"name":"Trinity College Dublin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"S147895152510120X_ref35","doi-asserted-by":"publisher","DOI":"10.1136\/spcare-2024-005144"},{"key":"S147895152510120X_ref16","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-016-0082-y"},{"key":"S147895152510120X_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/10499091241255117"},{"key":"S147895152510120X_ref5","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12521"},{"key":"S147895152510120X_ref14","volume-title":"Qualitative Research Methods","author":"Hennink","year":"2020"},{"key":"S147895152510120X_ref23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2022-003525"},{"key":"S147895152510120X_ref21","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-021-00768-5"},{"key":"S147895152510120X_ref4","volume-title":"Thematic Analysis: A Practical Guide","author":"Braun","year":"2021"},{"key":"S147895152510120X_ref32","doi-asserted-by":"publisher","DOI":"10.1108\/QRJ-07-2024-0153"},{"key":"S147895152510120X_ref8","doi-asserted-by":"publisher","DOI":"10.1089\/pmr.2024.0047"},{"key":"S147895152510120X_ref18","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol31060253"},{"key":"S147895152510120X_ref30","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15164076"},{"key":"S147895152510120X_ref31","volume-title":"Sage Research Methods: Doing Research Online","author":"Shelton","year":"2022"},{"key":"S147895152510120X_ref3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2015-000979"},{"key":"S147895152510120X_ref19","doi-asserted-by":"publisher","DOI":"10.4324\/9781315179568"},{"key":"S147895152510120X_ref11","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-019-0417-3"},{"key":"S147895152510120X_ref6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0212967"},{"key":"S147895152510120X_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.esmoop.2022.100496"},{"key":"S147895152510120X_ref7","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2014.0373"},{"key":"S147895152510120X_ref12","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15143551"},{"key":"S147895152510120X_ref27","doi-asserted-by":"publisher","DOI":"10.1111\/jan.16705"},{"key":"S147895152510120X_ref20","unstructured":"Lumivero (2023) NVivo (Version 14) www.lumivero.com. 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Published by Cambridge University Press.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e3"}}