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Palliative Medicine
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General practitioners (GPs) and palliative care: perceived tasks and barriers in daily practice

Marieke M Groot

Myrra JFJ Vernooij-Dassen

Centre for Quality of Care Research, University Medical Centre Nijmegen, Nijmegen

Ben JP Crul

Pain Centre, University Medical Centre Nijmegen, Nijmegen

Richard PTM Grol

Centre for Quality of Care Research, University Medical Centre Nijmegan, Nijmegan

Background: General practitioners (GPs) play a crucial part in palliative care. The quality of care can be improved by investigating and addressing barriers perceived by GPs in daily practice. The aim of this study was to investigate GPs' task perception and barriers involved in palliative care.

Methods: Qualitative focus group study. We gathered together a group of GPs representing a broad range of experience in palliative care. Content analysis was performed to derive a comprehensive view of tasks and barriers in daily palliative care.

Results: GPs described their palliative care tasks as satisfactory and varied, but burdensome. Palliative care tasks included somatic and psychosocial care. Opinions differed with respect to whether the coordination of care belonged to the primary GP tasks. Barriers were classified according to three levels: (1) personal: barriers related to knowledge, skills, emotions; (2) relational: barriers concerning communication and collaboration; (3) organizational: barriers related to the organization of care and compartmentalization in healthcare.

Conclusions: This study revealed a complex web of tasks and barriers. It may be possible to trace back a problem (lack of knowledge, for example) on the personal level to an isolated knowledge gap, but the problem may well have originated from communication or compartmentalization problems. To maintain GPs' feeling of being at ease with palliative care requires helping them acquire the appropriate balance between technical and organizational interventions and a compassionate orientation to their terminally ill patients.

Key Words: focus groups • palliative care • physicians • family • quality of health care

Palliative Medicine, Vol. 19, No. 2, 111-118 (2005)
DOI: 10.1191/0269216305pm937oa
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