• Palliative medicine · Jul 2017

    'The horse has bolted I suspect': A qualitative study of clinicians' attitudes and perceptions regarding palliative rehabilitation.

    • Fiona Runacres, Heidi Gregory, and Anna Ugalde.
    • 1 Department of Palliative Care, Calvary Health Care Bethlehem, Melbourne, VIC, Australia.
    • Palliat Med. 2017 Jul 1; 31 (7): 642-650.

    BackgroundPalliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied.AimTo explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units.DesignQualitative study utilizing semi-structured interviews. Transcribed interviews were analysed using thematic analysis and major themes reported as results.ParticipantsAustralian palliative medicine physicians working in inpatient palliative care units.ResultsIn total, 20 physicians participated, representing specialist palliative care services across Australia. A total of 11 (55%) were males with an average of 12.5 years' experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care; however, few felt adequate rehabilitation programmes were available. Participants varied in their concepts of what palliative rehabilitation entailed. The term rehabilitation was seen by some as helpful (fostering hope and aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians' attitudes, including (1) integrating rehabilitation within palliative care, (2) the intervention, (3) possibilities and (4) the message of rehabilitation.ConclusionA lack of consensus exists among palliative medicine specialists regarding the definition and scope of palliative rehabilitation. Participants generally expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base for palliative rehabilitation, to support its acceptance and widespread integration within specialist inpatient palliative care.

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