• Monica Fliedner, Sofia Zambrano, Jos Mga Schols, Marie Bakitas, Christa Lohrmann, Ruud Jg Halfens, and Steffen Eychmüller.
• 1 DOLS, University Center for Palliative Care, University Hospital Inselspital Bern, Bern, Switzerland.
• Palliat Med. 2019 Jul 1; 33 (7): 783-792.

BackgroundIntervention trials confirm that patients with advanced cancer receiving early palliative care experience a better quality of life and show improved knowledge about and use of palliative care services. To involve patients in future health-care decisions, health professionals should understand patients' perspectives. However, little is known about how patients' experience such interventions.AimTo explore advanced cancer patients' experiences with a structured early palliative care intervention, its acceptability and impact on the patients' life including influencing factors.DesignQualitative content analysis of in-depth, semi-structured interviews.Setting/ParticipantsPatients with various advanced cancer diagnoses were enrolled in a multicenter randomized controlled trial (NCT01983956), which investigated the impact of "Symptoms, End-of-life decisions, Network, Support," a structured early palliative care intervention, on distress. Of these, 20 patients who underwent the intervention participated in this study.ResultsParticipants received the intervention well and gained a better understanding of their personal situation. Patients reported that the intervention can feel "confronting" but with the right timing it can be confirming and facilitate family conversations. Patients' personal background and the intervention timing within their personal disease trajectory influenced their emotional and cognitive experiences; it also impacted their understanding of palliative care and triggered actions toward future care planning.ConclusionEarly palliative care interventions like "Symptoms, End-of-life decisions, Network, Support" may provoke emotions and feel "confrontational" often because this is the first time when issues about one's end of life are openly discussed; yet, advanced cancer patients found it beneficial and felt it should be incorporated into routine care.

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