Survey of oncology clinicians to identify barriers to PPC
involvement
Members of the project team (OO, SF, KL) developed a 6-question, short
answer survey which was emailed to all hematology oncology attendings,
fellows, social workers, and APRNs assessing barriers to PPC involvement
in pediatric oncology patients. The survey response rate was 65% (n=
76).Identified barriers included concerns that a patient and family may
have a negative view of palliative care which would adversely affect the
relationship with the oncology team, concerns for potential
communication issues, uncertainty about the right time to consult PPC,
lack of clarity regarding palliative care roles, and fear that PPC
involvement would be a burden to the family. Almost half (47%) of
respondents felt that all patients with a 5-year EFS of < 50%
at diagnosis should have PPC consulted at time of diagnosis, and more
than half (59%) felt that PPC should be involved at the time of relapse
or discussion of refractory disease. Based on these responses, the study
team created a key driver diagram (Figure 1)