P292 ‘The horse has bolted I suspect' – A Qualitative Study of Clinicians’ Practice and Attitudes Regarding Palliative Rehabilitation

Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices, and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. To explore palliative medicine physicians’ attitudes towards rehabilitation, and examine current models of palliative rehabilitation delivered within inpatient palliative care units. Australian palliative medicine physicians working in inpatient palliative care units were purposefully sampled and invited to participate in a semi-structured interview. Transcribed interviews were analysed using thematic analysis and major themes reported as results. Twenty physicians participated, representing specialist palliative care units across Australia. Eleven (55%) were male with an average of 12.5 years experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care, however few felt adequate rehabilitation programs were available. Varied concepts were described by participants about what constituted palliative rehabilitation. The term rehabilitation was seen by some as helpful (fostering hope, aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians’ attitudes, including 1) Integrating rehabilitation within palliative care, 2) The intervention, 3) Possibilities and 4) The message of rehabilitation. A lack of consensus exists amongst palliative medicine specialists regarding many aspects of palliative rehabilitation. Many participants expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base and consensus for palliative rehabilitation to support its integration within specialist inpatient palliative care.