[Experience of medical oncologists when telling a patient to be referred to a palliative care unit]

Abstract

Introduction: The announcement of the cessation of cancer treatments is a moment unanimously recognized as difficult for oncologists. More rarely analyzed, the announcement of a transfer to palliative care units is just as much. However, understanding the experience of oncologists during this announcement could make it possible to optimize it.

Materials and methods: Qualitative, prospective, monocentric study with medical oncologists. Semi-structured interviews with 7 open questions.

Results and discussion: Twelve interviews were conducted with a sex ratio of seven women for five men and an average age of 41.9 years. Six themes emerge after horizontal analysis of the verbatim and triangulation of the data. The experience of oncologists is dominated by a feeling of guilt, of fear of causing death anxiety in the patient, and of failure and helplessness in in front of a short-term vital risk. There is also a feeling of frustration at not being able to go through with the care. Facing the escape of the disease, oncologists feel resigned. We also observe projections on the part of oncologists with patients and paramedics. Finally, the existential question of death is an omnipresent concern with the feeling of abandoning the patient and a questioning of skills. However, it seems that the collaboration with the mobile palliative care team (EMSP) and the prospect of creating an internal palliative care unit (USP) at the center are perceived as a help.

Keywords: Analyse qualitative; Annonce de mauvaise nouvelle; Breaking bad news; Oncologists; Oncologues; Palliative care units; Qualitative analysis; Unités de soins palliatifs.