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Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists

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Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists. / Gerlach, Christina; Goebel, Swantje; Weber, Sascha; Weber, Martin; Sleeman, Katherine E.

In: PALLIATIVE MED, Vol. 33, No. 5, 05.2019, p. 531-540.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Gerlach, C, Goebel, S, Weber, S, Weber, M & Sleeman, KE 2019, 'Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists', PALLIATIVE MED, vol. 33, no. 5, pp. 531-540. https://doi.org/10.1177/0269216318824271

APA

Gerlach, C., Goebel, S., Weber, S., Weber, M., & Sleeman, K. E. (2019). Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists. PALLIATIVE MED, 33(5), 531-540. https://doi.org/10.1177/0269216318824271

Vancouver

Gerlach C, Goebel S, Weber S, Weber M, Sleeman KE. Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists. PALLIATIVE MED. 2019 May;33(5):531-540. https://doi.org/10.1177/0269216318824271

Bibtex

@article{9dda2d6e01e2498d8c71d6cf80db9818,
title = "Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists",
abstract = "BACKGROUND: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care.AIM: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany.DESIGN: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on the framework approach.SETTING/PARTICIPANTS: The study took place at the haemato-oncology outpatient clinic and the bone marrow transplantation outpatient clinic of a university hospital. Nine haemato-oncologists participated in qualitative interviews.RESULTS: Thematic analysis identified 4 themes and 11 subthemes: (1) meaning and relevance of the 'Surprise'-Question; (2) feasibility; (3) the concept of 'surprise' and (4) personal aspects of prognostication. A key function of the 'Surprise'-Question was to stimulate intuition and promote patient-centred goals of care by initiating a process of pause → reflection → change of perspective. It was easy and quick to use, but required time and communication skills to act on. Participants' training in palliative care enhanced their willingness to use the 'Surprise'-Question.CONCLUSION: Irrespective of its use in prognostication, the 'Surprise'-Question is a valuable tool to facilitate consideration of patient-centred goals and promote holistic care in haemato-oncology. However, prognostic uncertainty, lack of time and communication skills are barriers for integration into daily practice. Further research should involve haematology patients to integrate their needs and preferences.",
keywords = "Adult, Attitude of Health Personnel, Decision Making, Female, Germany, Hematologic Neoplasms/therapy, Hospitals, University, Humans, Interviews as Topic, Intuition, Male, Middle Aged, Oncologists/psychology, Palliative Care, Prognosis, Qualitative Research, Referral and Consultation",
author = "Christina Gerlach and Swantje Goebel and Sascha Weber and Martin Weber and Sleeman, {Katherine E}",
year = "2019",
month = may,
doi = "10.1177/0269216318824271",
language = "English",
volume = "33",
pages = "531--540",
journal = "PALLIATIVE MED",
issn = "0269-2163",
publisher = "SAGE Publications",
number = "5",

}

RIS

TY - JOUR

T1 - Space for intuition - the 'Surprise'-Question in haemato-oncology: Qualitative analysis of experiences and perceptions of haemato-oncologists

AU - Gerlach, Christina

AU - Goebel, Swantje

AU - Weber, Sascha

AU - Weber, Martin

AU - Sleeman, Katherine E

PY - 2019/5

Y1 - 2019/5

N2 - BACKGROUND: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care.AIM: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany.DESIGN: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on the framework approach.SETTING/PARTICIPANTS: The study took place at the haemato-oncology outpatient clinic and the bone marrow transplantation outpatient clinic of a university hospital. Nine haemato-oncologists participated in qualitative interviews.RESULTS: Thematic analysis identified 4 themes and 11 subthemes: (1) meaning and relevance of the 'Surprise'-Question; (2) feasibility; (3) the concept of 'surprise' and (4) personal aspects of prognostication. A key function of the 'Surprise'-Question was to stimulate intuition and promote patient-centred goals of care by initiating a process of pause → reflection → change of perspective. It was easy and quick to use, but required time and communication skills to act on. Participants' training in palliative care enhanced their willingness to use the 'Surprise'-Question.CONCLUSION: Irrespective of its use in prognostication, the 'Surprise'-Question is a valuable tool to facilitate consideration of patient-centred goals and promote holistic care in haemato-oncology. However, prognostic uncertainty, lack of time and communication skills are barriers for integration into daily practice. Further research should involve haematology patients to integrate their needs and preferences.

AB - BACKGROUND: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care.AIM: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany.DESIGN: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on the framework approach.SETTING/PARTICIPANTS: The study took place at the haemato-oncology outpatient clinic and the bone marrow transplantation outpatient clinic of a university hospital. Nine haemato-oncologists participated in qualitative interviews.RESULTS: Thematic analysis identified 4 themes and 11 subthemes: (1) meaning and relevance of the 'Surprise'-Question; (2) feasibility; (3) the concept of 'surprise' and (4) personal aspects of prognostication. A key function of the 'Surprise'-Question was to stimulate intuition and promote patient-centred goals of care by initiating a process of pause → reflection → change of perspective. It was easy and quick to use, but required time and communication skills to act on. Participants' training in palliative care enhanced their willingness to use the 'Surprise'-Question.CONCLUSION: Irrespective of its use in prognostication, the 'Surprise'-Question is a valuable tool to facilitate consideration of patient-centred goals and promote holistic care in haemato-oncology. However, prognostic uncertainty, lack of time and communication skills are barriers for integration into daily practice. Further research should involve haematology patients to integrate their needs and preferences.

KW - Adult

KW - Attitude of Health Personnel

KW - Decision Making

KW - Female

KW - Germany

KW - Hematologic Neoplasms/therapy

KW - Hospitals, University

KW - Humans

KW - Interviews as Topic

KW - Intuition

KW - Male

KW - Middle Aged

KW - Oncologists/psychology

KW - Palliative Care

KW - Prognosis

KW - Qualitative Research

KW - Referral and Consultation

U2 - 10.1177/0269216318824271

DO - 10.1177/0269216318824271

M3 - SCORING: Journal article

C2 - 30688151

VL - 33

SP - 531

EP - 540

JO - PALLIATIVE MED

JF - PALLIATIVE MED

SN - 0269-2163

IS - 5

ER -