{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:27:10Z","timestamp":1767626830377,"version":"build-2065373602"},"reference-count":70,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT\u2014Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia, I.P.","award":["UID\/05704\/2023"],"award-info":[{"award-number":["UID\/05704\/2023"]}]},{"name":"Scientific Employment Stimulus-Institutional Call","award":["UID\/05704\/2023"],"award-info":[{"award-number":["UID\/05704\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Background\/Objectives: The prevalence of people with incurable and progressive diseases in primary health care is high. Family doctors and nurses must be active agents in the early identification of palliative needs and the implementation of palliative approaches in cases of low to intermediate complexity. While there is a need for early referral of more complex palliative care (PC) cases to specialized teams, primary health care (PHC) professionals lack the confidence or skill to describe their role. This study sought to explore and describe (a) the practices of PHC professionals regarding their PC provision; (b) the barriers regarding access and referral of patients to specialized PC services; and (c) the strategies used or recommended to mitigate difficulties in accessing and referring to specialized PC. Methods: A descriptive qualitative study was carried out, using five focus groups conducted with nursing and medical staff at three local health units in the central region of Portugal. Semi-structured interviews were conducted, and then recorded, transcribed, and analyzed through a thematic analysis approach. The reporting of this research follows the COREQ checklist. Results: In total, 34 PHC professionals participated in this study. The majority of participants were women (n = 26) and family doctors (n = 24). Their mean age was 43.8 \u00b1 11.9 (range: 29 to 65 years). The findings were organized into three core themes: (1) the contours of palliative action developed by PHC teams; (2) barriers to access and safe transition between PHC and specialized PC; and (3) ways to mitigate difficulties in accessing and referring to specialized PC. Conclusions: Our findings highlight the fundamental role of PHC professionals in providing primary PC, and in identifying PC needs and referring patients to PC early on, while exposing the systemic and interpersonal challenges that hinder these processes. To overcome these challenges, it is essential to invest in the development of integrated care models that promote practical, low-bureaucratic referral processes and capture the human resources necessary for the adequate follow-up of users.<\/jats:p>","DOI":"10.3390\/healthcare13131576","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T09:29:01Z","timestamp":1751362141000},"page":"1576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Practices of Portuguese Primary Health Care Professionals in Palliative Care Access and Referral: A Focus Group Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Camila","family":"Barreto","sequence":"first","affiliation":[{"name":"USF Buarcos, Local Health Unit of Baixo Mondego, Av. Dr. M\u00e1rio Soares 64, 3080-254 Figueira da Foz, Portugal"},{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4872-7252","authenticated-orcid":false,"given":"Marcelle Miranda da","family":"Silva","sequence":"additional","affiliation":[{"name":"Escola de Enfermagem Anna Nery (EEAN), Universidade Federal do Rio de Janeiro (UFRJ), Afonso Cavalcanti Street, Rio de Janeiro 21211-110, Brazil"}]},{"given":"Ana F\u00e1tima Carvalho","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}]},{"given":"Romel Jonathan Velasco","family":"Yanez","sequence":"additional","affiliation":[{"name":"Department of Nursing, Federal University of Cear\u00e1, Fortaleza 60430-160, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1080-9535","authenticated-orcid":false,"given":"Carlos","family":"Laranjeira","sequence":"additional","affiliation":[{"name":"School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901 Leiria, Portugal"},{"name":"Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal"},{"name":"Comprehensive Health Research Centre (CHRC), University of \u00c9vora, 7000-801 \u00c9vora, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Veronese, N. 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