TY - JOUR

T1 - Barriers and facilitators to national guideline implementation for palliative cancer care in a Danish cross-sectoral healthcare setting

T2 - A qualitative study of healthcare professionals' experiences

AU - Sørensen, Dina Melanie

AU - Dalton, Susanne Oksbjerg

AU - Egholm, Cecilie Lindström

AU - Bidstrup, Pernille

AU - Brodersen, John Brandt

AU - Rosted, Elizabeth

N1 - Publisher Copyright: © 2023 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd.

PY - 2024

Y1 - 2024

N2 - Objective: Patients with incurable cancer should receive general palliative care according to their needs, as provided through collaboration between hospital departments, municipalities, and general practices and as outlined in national guidelines. However, the implementation of general palliative care in Denmark has been inadequate. This study aimed to investigate the healthcare professionals' (HCPs') perceptions on barriers to and facilitators of the implementation of the Danish National Guideline (NG) for general palliative care. Methods: This descriptive, qualitative study was guided by the Consolidated Framework for Implementation Research (CFIR). Qualitative focus group and individual interviews were conducted with 23 HCPs. The interview guide, coding, analysis, and reporting of findings were developed within the CFIR framework. Results: The main barriers to implementing NG were as follows: lack of knowledge about the NG, lack of an implementation plan, and insufficient communication and collaboration across sectors. Important facilitators were as follows: HCP motivation to meet palliative care needs, HCPs with special functions taking responsibility for incorporating NG into local guidelines, and the role of district nurses specialised in palliative care as opinion leaders providing security and continuity for the HCPs working in palliative care. Conclusions: To address the needs of patients with incurable cancer, greater efforts are required on implementing general palliative care. Although HCPs in our setting were motivated to improve NG implementation, financial resources and strategies are necessary to ensure sufficient knowledge uptake and accommodate identified barriers in order to translate the NG into practice.

AB - Objective: Patients with incurable cancer should receive general palliative care according to their needs, as provided through collaboration between hospital departments, municipalities, and general practices and as outlined in national guidelines. However, the implementation of general palliative care in Denmark has been inadequate. This study aimed to investigate the healthcare professionals' (HCPs') perceptions on barriers to and facilitators of the implementation of the Danish National Guideline (NG) for general palliative care. Methods: This descriptive, qualitative study was guided by the Consolidated Framework for Implementation Research (CFIR). Qualitative focus group and individual interviews were conducted with 23 HCPs. The interview guide, coding, analysis, and reporting of findings were developed within the CFIR framework. Results: The main barriers to implementing NG were as follows: lack of knowledge about the NG, lack of an implementation plan, and insufficient communication and collaboration across sectors. Important facilitators were as follows: HCP motivation to meet palliative care needs, HCPs with special functions taking responsibility for incorporating NG into local guidelines, and the role of district nurses specialised in palliative care as opinion leaders providing security and continuity for the HCPs working in palliative care. Conclusions: To address the needs of patients with incurable cancer, greater efforts are required on implementing general palliative care. Although HCPs in our setting were motivated to improve NG implementation, financial resources and strategies are necessary to ensure sufficient knowledge uptake and accommodate identified barriers in order to translate the NG into practice.

KW - barriers

KW - cancer

KW - CFIR

KW - cross-sectoral collaboration

KW - facilitators

KW - implementation

KW - national guidelines

KW - oncology

KW - palliative care

KW - qualitative methods

U2 - 10.1002/pon.6267

DO - 10.1002/pon.6267

M3 - Journal article

C2 - 38078707

AN - SCOPUS:85179301220

VL - 33

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 1

M1 - e6267

ER -