{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:36:53Z","timestamp":1792795013963,"version":"4.5.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T00:00:00Z","timestamp":1600128000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Liverpool Clinical Commissioning Group","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Palliat Care"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To report on direct experiences from advanced head and neck cancer patients, family carers and healthcare professionals, and the barriers to integrating specialist palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using a naturalistic, interpretative approach, within Northwest England, a purposive sample of adult head and neck cancer patients was selected. Their family carers were invited to participate. Healthcare professionals (representing head and neck surgery and specialist nursing; oncology; specialist palliative care; general practice and community nursing) were recruited. All participants underwent face-to-face or telephone interviews. A thematic approach, using a modified version of Colazzi\u2019s framework, was used to analyze the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Seventeen interviews were conducted (9 patients, 4 joint with family carers and 8 healthcare professionals). Two main barriers were identified by healthcare professionals: \u201clack of consensus about timing of Specialist Palliative Care engagement\u201d and \u201chigh stake decisions with uncertainty about treatment outcome.\u201d The main barrier identified by patients and family carers was \u201clack of preparedness when transitioning from curable to incurable disease.\u201d There were 2 overlapping themes from both groups: \u201cuncertainty about meeting psychological needs\u201d and \u201cmisconceptions of palliative care.\u201d<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Head and neck cancer has a less predictable disease trajectory, where complex decisions are made and treatment outcomes are less certain. Specific focus is needed to define the optimal way to initiate Specialist Palliative Care referrals which may differ from those used for the wider cancer population. Clearer ways to effectively communicate goals of care are required potentially involving collaboration between Specialist Palliative Care and the wider head and neck cancer team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0825859720957817","type":"journal-article","created":{"date-parts":[[2020,9,15]],"date-time":"2020-09-15T04:29:56Z","timestamp":1600144196000},"page":"121-129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["A Qualitative Study Exploring Patient, Family Carer and Healthcare Professionals\u2019 Direct Experiences and Barriers to Providing and Integrating Palliative Care for Advanced Head and Neck Cancer"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1440-9953","authenticated-orcid":false,"given":"Catriona Rachel","family":"Mayland","sequence":"first","affiliation":[{"name":"Department of Oncology and Metabolism, University of Sheffield, United Kingdom"},{"name":"Palliative Care Institute, University of Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah C.","family":"Doughty","sequence":"additional","affiliation":[{"name":"Palliative Care Institute, University of Liverpool, United Kingdom"},{"name":"Department of Primary Care and Mental Health, University of Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon N.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom"},{"name":"Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gola","sequence":"additional","affiliation":[{"name":"Marie Curie Palliative Care Research Department, University College London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4020-6869","authenticated-orcid":false,"given":"Stephen","family":"Mason","sequence":"additional","affiliation":[{"name":"Palliative Care Institute, University of Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathy","family":"Hubbert","sequence":"additional","affiliation":[{"name":"Aintree Park General Practice, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominic","family":"Macareavy","sequence":"additional","affiliation":[{"name":"Aintree University Hospitals NHS Foundation Trust, Liverpool, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A.","family":"Jack","sequence":"additional","affiliation":[{"name":"Faculty of Health and Social Care, Edge Hill University, Ormskirk, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,15]]},"reference":[{"key":"bibr1-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1177\/0269216318775264"},{"key":"bibr2-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23053"},{"key":"bibr3-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1080\/0036554021000028072"},{"key":"bibr4-0825859720957817","doi-asserted-by":"publisher","DOI":"10.4103\/0973-1075.191854"},{"key":"bibr5-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1300\/J010v40n02_05"},{"key":"bibr6-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1177\/082585971403000102"},{"key":"bibr7-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.2480"},{"key":"bibr8-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1080\/07347332.2016.1195901"},{"key":"bibr9-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12619"},{"issue":"1","key":"bibr10-0825859720957817","first-page":"153","volume":"25","author":"Satija A","year":"2019","journal-title":"Indian J Palliative Care"},{"key":"bibr11-0825859720957817","unstructured":"National End of Life Care Intell Network. Head and neck cancers in England: who dies from them and where do they die? 2014. https:\/\/webarchive.nationalarchives.gov.uk\/20190501131928\/http:\/\/www.endoflifecare-intelligence.org.uk\/resources\/publications\/head_and_neck. Accessed September 7, 2020."},{"key":"bibr12-0825859720957817","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21490"},{"key":"bibr13-0825859720957817","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2925"},{"key":"bibr14-0825859720957817","doi-asserted-by":"crossref","unstructured":"Haun MW, Estel S, Rucker G, et al. Early palliative care for adults with advanced cancer. Cochrane systematic review. Cochrane Library. 2017.https:\/\/www.cochrane.org\/CD011129\/SYMPT_early-palliative-care-adults-advanced-cancer. 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