Attitudes of primary care providers on early palliative care, in new community settings of Attica, Greece; a qualitative analysis

Background: Early provision of palliative care globally can be achieved by primary health professionals. In Greece, a primary care reformation is currently under development; novel community units have been introduced, with the family physician working for the first time with an interdisciplinary team. Objectives/Setting: To explore the attitudes of such providers, on early palliative care in Attica. A clear understanding of primary care workforce attitudes would facilitate the National primary care strategic development. Participants/Design: Qualitative research design, with 3 focused-groups of 23 primary health care providers, including family physicians, nurses, health visitors, administrative assistants and sociologists. All were members of the Hellenic Association of Research and Education in Primary Care. Semi-structured question guides were used. Experiences, practices, needs and barriers were evaluated. Responses were audio recorded, transcribed, grouped under various themes, listed out and analyzed, through thematic analysis. Results: Three major themes were identified and all teams were able to: 1) Identify patient and family populations with palliative care unmet needs, early at diagnosis. 2) Respond to those needs by the holistic model of care and integrate strategies of early palliative care, working as a team. 3) Recognize barriers to the best-possible approach: a) lack of education on severe pain and grief management, b) lack of collaboration with experts, and c) instability of governmental decisions. Conclusions: Teams of primary care providers in Attica, could integrate early palliative care. Issues to be addressed include further education on pain and grief management, collaboration with palliative care experts and stability.