No votes yet
Journal Club

Oncology Nurses' Perceptions About Palliative Care

Carol Pavlish
Lyn Ceronsky
ONF 2007, 34(4), 793-800 DOI: 10.1188/07.ONF.793-800

Purpose/Objectives: To explore oncology nurses' perceptions about palliative care.

Research Approach: Descriptive study with narrative data analysis.

Setting: Oncology units in three midwestern hospitals.

Participants: 33 actively practicing oncology nurses.

Methodologic Approach: Oncology nurses participated in focus groups that elicited concrete experiences and reflections about palliative care. Researchers identified subtexts by which to sort data, worked inductively in each subtext to identify categories, resorted the text according to the categories, carefully examined the category narratives, and established narrative descriptors that captured the essence of each category. Data matrices were constructed to examine the emerging categories more closely.

Main Research Variable: Oncology nurses' perceptions about palliative care.

Findings: Narratives revealed 14 descriptors about palliative care. Considerable agreement occurred in nurses' descriptions about the nature of palliative care. Divergent viewpoints were evident as nurses described how palliative care intersects with other practice areas. Three descriptors of the healthcare context in which palliative care occurs were identified: limited time for addressing complex palliative care issues, health care's emphasis on prolonging life, and the challenge of coordinating care across disciplines.

Conclusions: Participants clearly comprehend palliative care goals. However, divergent perspectives about the intersections of palliative care with oncology nursing may limit timely consultation with specialty palliative care teams. The current acute care context poses challenges to implementing palliative care.

Interpretation: Palliative care teams and oncology nurses need to develop partnership models that clearly illustrate how both partners contribute to palliative care across the continuum of oncology care. Furthermore, the partnership models must address barriers that the acute care context poses to quality palliative care.


Averill, J. (2002). Matrix analysis as a complement to analytic strategy in qualitative inquiry. <i>Qualitative Health Research</i>, <b>12</b>, 855-866.

Bertero, C. (2002). District nurses' perceptions of palliative care in the home. <i>American Journal of Hospice and Palliative Care</i>, <b>19</b>, 387-391.

Bradley, E., Cherlin, E., McCorkle, R., Fried, T., Kasl, S., Cicchetti, D., et al. (2001). Nurses' use of palliative care practices in the acute care setting. <i>Journal of Professional Nursing</i>, <b>17</b>, 14-22.

Bruce, S. (2006, May). Palliative care: Helping patients live longer—and better—with cancer. <i>ONS News</i>, <b>21</b>(5), 1, 4, 6.

Contro, N., Larson, J., Scofield, S., Sourkes, B., & Cohen, H. (2002). Family perspectives on the quality of pediatric palliative care. <i>Archives of Pediatric and Adolescent Medicine</i>, <b>156</b>, 14-19.

Cutcliffe, J., Black, C., Hanson, E., & Goward, P. (2001). The commonality and synchronicity of mental health nurses and palliative care nurses: Closer than you think? <i>Journal of Psychiatric and Mental Health Nursing</i>, <b>8</b>, 61-66.

Davidson, P., Introna, K., Daly, J., Paull, G., Jarvis, R., Angus, J., et al. (2003). Cardiorespiratory nurses' perceptions of palliative care in nonmalignant disease: Data for the development of clinical practice. <i>American Journal of Critical Care</i>, <b>12</b>, 47-54.

Ferris, F., von Gunten, C., & Emanuel, L. (2001). Knowledge: Insufficient for change. <i>Journal of Palliative Medicine</i>, <b>4</b>, 145-147.

Gadamer, H. (1987). The problem of historical consciousness (J.L. Close, Trans.). In P. Rabinow & W. Sullivan (Eds.), <i>Interpretive social science: A second look</i> (pp. 82-140). Los Angeles, CA: University of California Press. (Original work published 1963)

Gross, A. (2006). End-of-life care obstacles and facilitators in the critical care units of a community hospital. <i>Journal of Hospice and Palliative Nursing</i>, <b>8</b>, 92-102.

Hanratty, B., Hibbert, D., Mair, F., May, C., Ward, C., Capewell, S., et al. (2002). Doctors' perceptions of palliative care for heart failure: Focus group study. <i>BMJ</i>, <b>325</b>, 581-585.

Institute of Medicine. (2001). <i>Improving palliative care for cancer.</i> Washington, DC: National Academies Press.

Krueger, R., & Casey, M. (2000). <i>Focus groups: A practical guide for applied research.</i> Thousand Oaks, CA: Sage.

Lieblich, A., Tuval-Mashiach, R., & Zilber, T. (1998). <i>Narrative research: Reading, analysis, and interpretation.</i> Thousand Oaks, CA: Sage.

Lipman, A. (2002). Pain management and palliative care services: A natural and needed synergy. <i>APS Bulletin</i>, <b>12</b>, 5.

Lo, B., Snyder, L., & Sox, H. (1999). Care at the end of life: Guiding practice where there are no easy answers. <i>Annals of Internal Medicine</i>, <b>130</b>, 772-773.

Lynn, J. (2001). Serving patients who may die soon and their families: The role of hospice and other services. <i>JAMA</i>, <b>285</b>, 925-932.

Lynn, J., Teno, J., Phillips, R., Wu, A., Desbiens, N., Harrold, J., et al. (1997). Perceptions by family members of the dying experience of older and seriously ill patients. <i>Annals of Internal Medicine</i>, <b>126</b>, 97-106.

Magno, J.B. (1990). The hospice concept of care: Facing the 1990s. <i>Death Studies</i>, <b>14</b>, 109-119.

Meghani, S. (2004). A concept analysis of palliative care in the United States. <i>Journal of Advanced Nursing</i>, <b>46</b>, 152-161.

Meier, D., Morrison, S., & Cassel, C. (1997). Improving palliative care. <i>Annals of Internal Medicine</i>, <b>127</b>, 225-230.

Miles, M., & Huberman, A. (1994). <i>Qualitative data analysis.</i> Thousand Oaks, CA: Sage.

Mok, E., & Chiu, P. (2004). Nurse-patient relationships in palliative care. <i>Journal of Advanced Nursing</i>, <b>48</b>, 475-483.

Morgan, D. (2002). Focus group interviewing. In J. Gubrium & J. Holstein (Eds.), <i>Handbook of interview research: Context and method</i> (pp. 141-160). Thousand Oaks, CA: Sage.

Morse, J., & Field, P. (1995). <i>Qualitative research methods for health professionals.</i> Thousand Oaks, CA: Sage.

National Comprehensive Cancer Network. (2006). <i>Clinical practice guidelines in oncology: Palliative care.</i> Retrieved December 28, 2006, from <a target="_blank" href='http://www.nccn.org/professionals/physician_gls/pdf/palliative.pdf'>http...

Patton, M. (2002). <i>Qualitative research and evaluation methods.</i> Thousand Oaks, CA: Sage.

Ricoeur, P. (1991). Life in quest of narrative. In D. Wood (Ed.), <i>On Paul Ricoeur: Narrative and interpretation</i> (pp. 20-33). New York: Routledge.

Ronaldson, S., & Devery, K. (2001). The experience of transition to palliative care services: Perspectives of patients and nurses. <i>International Journal of Palliative Nursing</i>, <b>7</b>, 171-177.

Teno, J., Clarridge, B., Casey, V., Weoch, L., Wetle, T., Shield, R., et al. (2004). Family perspectives on end-of-life care as the last place of care. <i>JAMA</i>, <b>291</b>, 88-93.

Willard, C., & Luker, K. (2005). Supportive care in the cancer setting: Rhetoric or reality? <i>Palliative Medicine</i>, <b>19</b>, 328-333.