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Nurses' perceptions of proactive palliative care: a Dutch focus group study.

BACKGROUND
Early identification of pain and other problems is an important aspect of palliative care. Although nurses have an important role in palliative care, little is known about nurses' perceptions of proactive palliative care.


OBJECTIVES
This study aimed to explore nurses' perceptions and experiences of proactive identification of problems and requirements among patients with palliative care needs.


METHODS
This was a qualitative study in which 16 nurses working in palliative care took part in two focus groups.


RESULTS
All of the nurses underlined the importance of their early involvement in palliative care. Anticipation of possible future problems, advice and information about end-of-life care and palliative care facilities, and assessment of patients' wishes regarding care and preferred place of death were mentioned as important aspects of the early identification of problems and needs. Four themes were identified: the start of proactive palliative care; communication, support, and guidance; advocating for patients; and cooperation with health professionals.


CONCLUSIONS
Nurses' involvement in proactive palliative care is important in supporting patients' palliative care management. Ongoing education, focused on multidisciplinary communication and cooperation, professional development, and empowerment of nurses, remains of utmost importance.