What Are the Factors Influencing the Referral of Patients with Haematological Cancer to Palliative Care? A Systematised Literature Review

Abstract

Abstract Background: Improved quality of life is reported for patients with cancerous and non-cancerous conditions who receive early palliative care. However, growing evidence suggests frequent delays in palliative care referrals for patients with haematological cancer. Aim: To answer the question: ‘What are the factors influencing the referral of patients with haematological cancer to palliative care?’ Methods: A systematised literature review with narrative synthesis was conducted in response to a question formulated using the PEO strategy (population, exposure, outcomes). CINAHL, Medline, PubMed, PsycINFO, and Web of Science were searched for English language primary research on palliative care, referrals and haematological cancer, published July 2015-April 2020. Selection was completed with Covidence software, followed by CASP, MMAT and JBI critical appraisal checklists to assess quality. Results: Six studies met the inclusion criteria (total participants=208): four qualitative (two phenomenological; two grounded theory), one cross-sectional survey, and one mixed methods. From a healthcare professional perspective, several influencing factors were identified, along with three distinct themes: disease condition, healthcare professionals’ issues, and hospital infrastructural issues. Nevertheless, selection and results bias potentially impaired methodological quality in two studies. Conclusion: This current review has answered the review question, but only from the healthcare professional standpoint (no patient perspectives). Therefore, further studies are urgently required to examine the influencing factors from the patients’ perspective, comprehensively determining the factors of influence and ensuring a better understanding of patients’ preferences. Dissemination: This systematised review will be disseminated in poster form at the 2021 International Society of Nurses in Cancer Care Conference.