{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:58:17Z","timestamp":1772344697456,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017014","name":"Centro de Investiga\u00e7\u00e3o em Tecnologias e Servi\u00e7os de Sa\u00fade","doi-asserted-by":"publisher","award":["This article was supported by National Funds through FCT - Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDB\/4255\/2020)"],"award-info":[{"award-number":["This article was supported by National Funds through FCT - Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia,I.P., within CINTESIS, R&D Unit (reference UIDB\/4255\/2020)"]}],"id":[{"id":"10.13039\/501100017014","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Aggravated by the COVID-19 pandemic, the provision of palliative care for patients with palliative care needs emerges as a necessity more than ever. Most are managed in primary care by their family physicians (FP). This study aimed to understand the perspectives of specialist and trainee FPs about their role in palliative care. Methods: we conducted a double focus-group study consisting of two separate online focus-groups, one with FP specialists (n = 9) and one with FP trainees (n = 10). Results: FPs already gather two fundamental skills for the provision of palliative care: the capacity to identify patients\u2019 needs beyond physical symptoms and the recognition that the patient belongs to a familiar, psychosocial, and even spiritual environment. They perceive their role in palliative care to be four-fold: early identification of patients with palliative care needs, initial treatment, symptom management, and patient advocacy. Participants recognized the need for palliative care training and provided suggestions for training programs. Conclusion: FPs share a holistic approach and identify multiple roles they can play in palliative care, from screening to care and advocacy. Organizational barriers must be addressed. Short training programs that combine theory, practice, and experiential learning may further the potential for FPs to contribute to palliative care.<\/jats:p>","DOI":"10.3390\/ijerph18147282","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T12:31:25Z","timestamp":1625661085000},"page":"7282","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Family Physicians\u2019 Perspectives on Their Role in Palliative Care: A Double Focus Group in Portugal"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9214-6995","authenticated-orcid":false,"given":"Carlos Sei\u00e7a","family":"Cardoso","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal"},{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2849-5194","authenticated-orcid":false,"given":"Filipe","family":"Prazeres","sequence":"additional","affiliation":[{"name":"CINTESIS\u2014Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Faculdade de Ci\u00eancias da Sa\u00fade, Universidade da Beira Interior, 6201-001 Covilh\u00e3, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1787-4586","authenticated-orcid":false,"given":"Beatriz","family":"Xavier","sequence":"additional","affiliation":[{"name":"Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3046-851 Coimbra, Portugal"}]},{"given":"B\u00e1rbara","family":"Gomes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal"},{"name":"Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King\u2019s College London, London WC2R 2LS, UK"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/S0140-6736(14)61347-7","article-title":"The burden of disease in older people and implications for health policy and practice","volume":"385","author":"Prince","year":"2015","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1111\/j.1365-2702.2007.02220.x","article-title":"A critical literature review exploring the challenges of delivering effective palliative care to older people with dementia","volume":"17","author":"Birch","year":"2008","journal-title":"J. Clin. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1016\/j.jacc.2017.08.036","article-title":"Palliative Care in Heart Failure: Rationale, Evidence, and Future Priorities","volume":"70","author":"Kavalieratos","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1377\/hlthaff.2010.0929","article-title":"The care span: Palliative care consultation teams cut hospital costs for Medicaid beneficiaries","volume":"30","author":"Morrison","year":"2011","journal-title":"Health Aff."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/0269216314545006","article-title":"Promoting Palliative Care in the Community: Production of the Primary Palliative Care Toolkit by the European Association of Palliative Care Taskforce in Primary Palliative Care","volume":"29","author":"Murray","year":"2015","journal-title":"Palliat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1191\/0269216302pm573oa","article-title":"How Well Do General Practitioners Deliver Palliative Care? A Systematic Review","volume":"16","author":"Mitchell","year":"2002","journal-title":"Palliat. Med."},{"key":"ref_7","first-page":"240","article-title":"Home Care of Dying Patients. Family physicians\u2019 Experience with a Palliative Care Support Team","volume":"40","author":"McWhinney","year":"1994","journal-title":"Can. Fam. Physician Med. Fam. Can."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jpainsymman.2018.11.006","article-title":"Prevalence and Characteristics of Patients Being at Risk of Deteriorating and Dying in Primary Care","volume":"57","author":"Hamano","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1177\/0269216313518266","article-title":"Prevalence and Characteristics of Patients with Advanced Chronic Conditions in Need of Palliative Care in the General Population: A Cross-Sectional Study","volume":"28","author":"Blay","year":"2014","journal-title":"Palliat. Med."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Hall, S., Davies, E., Frogatt, K., Higginson, I., and Kolliakou, A. (2008). Interventions for improving palliative care for older people living in nursing care homes. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD007132"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1177\/1049909115577352","article-title":"Is There a Need for Early Palliative Care in Patients With Life-Limiting Illnesses? Interview Study with Patients about Experienced Care Needs from Diagnosis Onward","volume":"33","author":"Beernaert","year":"2016","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1177\/0269216314528742","article-title":"General practitioners\u2019 Perspectives on the Avoidability of Hospitalizations at the End of Life: A Mixed-Method Study","volume":"28","author":"Pasman","year":"2014","journal-title":"Palliat. Med."},{"key":"ref_13","unstructured":"Rezabek, R.J. (2021, April 29). Online Focus Groups: Electronic Rezabek, Roger. Online Focus Groups: Electronic Discussions for Research [67 paragraphs]. Forum Qualitative Sozialforschung\/Forum: Qualitative Social Research. Available online: http:\/\/nbn-resolving.de\/urn:nbn:de:0114-fqs0001185."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tates, K., Zwaanswijk, M., Otten, R., Van Dulmen, S., Hoogerbrugge, P.M., Kamps, W.A., and Bensing, J.M. (2009). Online Focus Groups As a Tool to Collect Data in Hard-to-Include Populations: Examples from Paediatric Oncology. BMC Med. Res. Methodol., 9.","DOI":"10.1186\/1471-2288-9-15"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Cooper, H., Camic, P.M., Long, D.L., Panter, A.T., Rindskopf, D., and Sher, K.J. (2012). APA Handbook of Research Methods in Psychology, Vol. 2. Research Designs: Quantitative, Qualitative, Neuropsychological, and Biological, American Psychological Association.","DOI":"10.1037\/13620-000"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"E484","DOI":"10.1503\/cmaj.160775","article-title":"The \u201csurprise question\u201d for Predicting Death in Seriously Ill Patients: A Systematic Review and Meta-Analysis","volume":"189","author":"Downar","year":"2017","journal-title":"Can. Med. Assoc. J."},{"key":"ref_17","unstructured":"Wonca Europe (2002). The European Definition of General Practice\/Family Medicine, WHO Europe Office."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1016\/S0140-6736(13)62416-2","article-title":"Early Palliative Care for Patients with Advanced Cancer: A Cluster-Randomised Controlled Trial","volume":"383","author":"Zimmermann","year":"2014","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S1470-2045(18)30060-3","article-title":"Effect of Early and Systematic Integration of Palliative Care in Patients with Advanced Cancer: A Randomised Controlled Trial","volume":"19","author":"Vanbutsele","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3322\/caac.21490","article-title":"Improving Patient and Caregiver Outcomes in Oncology: Team-Based, Timely, and Targeted Palliative Care","volume":"68","author":"Hui","year":"2018","journal-title":"CA A Cancer J. Clin."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1089\/jpm.2006.0155","article-title":"Perceptions and Utilization of Palliative Care Services in Acute Care Hospitals","volume":"10","author":"Rodriguez","year":"2007","journal-title":"J. Palliat. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"388","DOI":"10.32385\/rpmgf.v27i4.10870","article-title":"O que ocupa os m\u00e9dicos de fam\u00edlia? Caracteriza\u00e7\u00e3o do trabalho m\u00e9dico para al\u00e9m da consulta","volume":"27","author":"Granja","year":"2011","journal-title":"Rev. Port. Cl\u00ednica Geral"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1911146","DOI":"10.1001\/jamanetworkopen.2019.11146","article-title":"Early Identification of People Who Would Benefit From a Palliative Approach-Moving From Surprise to Routine","volume":"2","author":"Downar","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1136\/bmj.297.6644.337","article-title":"Domiciliary consultations: Some facts and questions","volume":"297","author":"Fry","year":"1988","journal-title":"Br. Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.pbj.2015.07.002","article-title":"Palliative Care and the Portuguese Health System","volume":"1","author":"Nunes","year":"2016","journal-title":"Porto Biomed. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1093\/eurpub\/ckv052","article-title":"Impact of Living Alone on Institutionalization and Mortality: A Population-Based Longitudinal Study","volume":"26","author":"Pimouguet","year":"2016","journal-title":"Eur. J. Public Health"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1177\/0269216320929552","article-title":"Identification of Patients With Potential Palliative Care Needs: A Systematic Review of Screening Tools in Primary Care","volume":"34","author":"ElMokhallalati","year":"2020","journal-title":"Palliat. Med."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7282\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:27:18Z","timestamp":1760164038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/14\/7282"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,7]]},"references-count":27,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2021,7]]}},"alternative-id":["ijerph18147282"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18147282","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,7]]}}}