A Program to Improve General Palliative Cancer Care Guideline Implementation: Development, Acceptability, and Feasibility of Implementation Strategies

一项旨在改进癌症姑息治疗指南实施的计划:实施策略的制定、可接受性和可行性

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Abstract

RATIONALE: Implementing palliative care for patients with cancer in the healthcare sector is a complex task. Some patients with cancer do not receive timely and comprehensive palliative care tailored to their needs, potentially reducing their quality of life. AIMS AND OBJECTIVES: The goal is to develop an Implementation Program to improve the implementation of the national guidelines for general palliative cancer care. Moreover, the study aims to evaluate the acceptability and feasibility of the implementation strategies among healthcare professionals. DESIGN: We used a participatory action research approach and the Quality Implementation Framework to guide the program. Additionally, we evaluated the acceptability and feasibility of the implementation strategies through a qualitative descriptive design. METHODS: Thirty-one healthcare professionals from oncology, municipalities, and general practice took part in developing the Implementation Program with guidance from a facilitator. We utilized data triangulation, including qualitative interviews (n = 17), observation data from in-person meetings (n = 5), virtual meetings (n = 50), and process data gathered from November 2021 to March 2023. We analyzed the data using Content Analysis methods. RESULTS: A program comprising 14 critical steps was developed. The implementation strategies were found acceptable and feasible, particularly for cross-sectoral networking and a facilitator supporting collaboration. However, Plan-Do-Study-Act cycles were considered problematic. The value of learning from experiences was recognized, and healthcare professionals appreciated the advantages of cross-sector collaboration. CONCLUSION: This study involved cross-sectoral healthcare professionals in developing the Implementation Program for general palliative cancer care. Networking is vital in this context and should be considered a stand-alone implementation strategy.

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