• Els Ml Verschuur, Marieke M Groot, and Rob van der Sande.
• Associate Professor, Faculty of Health and Social Studies, HAN University of Applied Sciences, Hogeschool van Arnhem en Nijmegen, BHH, Postbus 6960, 6503 GL Nijmegen, The Netherlands.
• Int J Palliat Nurs. 2014 May 1; 20 (5): 241-5.

BackgroundEarly identification of pain and other problems is an important aspect of palliative care. Although nurses have an important role in palliative care, little is known about nurses' perceptions of proactive palliative care.ObjectivesThis study aimed to explore nurses' perceptions and experiences of proactive identification of problems and requirements among patients with palliative care needs.MethodsThis was a qualitative study in which 16 nurses working in palliative care took part in two focus groups.ResultsAll of the nurses underlined the importance of their early involvement in palliative care. Anticipation of possible future problems, advice and information about end-of-life care and palliative care facilities, and assessment of patients' wishes regarding care and preferred place of death were mentioned as important aspects of the early identification of problems and needs. Four themes were identified: the start of proactive palliative care; communication, support, and guidance; advocating for patients; and cooperation with health professionals.ConclusionsNurses' involvement in proactive palliative care is important in supporting patients' palliative care management. Ongoing education, focused on multidisciplinary communication and cooperation, professional development, and empowerment of nurses, remains of utmost importance.

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