CanPROS Scientific Conference 2019 Poster Abstracts

Abstract

Background: Palliative care is an approach that improves quality of life for patients and families facing challenges associated with life-threatening illness. In Alberta, most people who received palliative care received it late. Late palliative care negatively affects patient and caregiver experiences and decreases quality of life. This study aims to understand patient and caregiver experiences of advanced colorectal cancer care to inform an early palliative care pathway for advanced cancer care. Methods: A qualitative study that is embedded within a larger program of research on the implementation of the Palliative Care Early and Systematic (paces) pathway. Semi-structured telephone interviews with patients and their caregivers living with advanced colorectal cancer were conducted to explore their experiences with cancer care services received before pathway implementation. Interviews were transcribed, and the data were thematically analyzed, supported by the qualitative analysis software NVivo. Results: Interviews with 15 patients and 7 caregivers from Edmonton and Calgary were conducted over the telephone. Most participants found the Putting Patients First tool to be useful at their appointments; however, some mentioned a preference for viewing their scores over time. A total of 6 main themes were identified: (1) Meaning of palliative care (2) Communication (3 main subthemes: communication of diagnosis, communication between patient and oncologist, communication between providers) (3) Relationship with health care providers (including oncologist, family doctor, and nurses) (4) Access to care (cost of care, proximity to care, after hours care) (5) Patient readiness for advance care planning (6) Patient and family engagement in care, with mixed experiences in how patients were involved in their care. Conclusions: Most participants misperceived palliative care to mean “end-of-life care,” suggesting a need for improvement in the delivery of palliative care information. Understanding the care experiences of patients and caregivers will inform the development of a care pathway for early palliative care.