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Original Article
- Exploring Oncologists’ Perspectives on the Early Integration of Specialty Palliative Care in Korea: Challenges, Needs, and Clinical Implications
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Shin Hye Yoo1
, Yu Jung Kim2, Ye Sul Jeung1, Jung Sun Kim3, Kwonoh Park4, Eun Mi Nam5, Si Won Lee6, Jun Ho Ji7, Jwa Hoon Kim8, Joon Young Hur9, Song Ee Park10, Jung Lim Lee11, Su-Jin Koh12
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DOI: https://doi.org/10.4143/crt.2025.158 [Accepted]
Published online: April 10, 2025
1Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea
2Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
3Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
4Division of Hematology-Oncology, Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea
5Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
6Division of Medical Oncology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Division of Hematology and Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
8Division of Medical Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
9Department of Hematology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
10Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul, Korea
11Division of Hematology and Medical Oncology, Department of Internal Medicine, Daegu Fatima Hospital Cancer Center, Daegu, Korea
12Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
2Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
3Division of Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
4Division of Hematology-Oncology, Department of Internal Medicine, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, Korea
5Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
6Division of Medical Oncology, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
7Division of Hematology and Oncology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
8Division of Medical Oncology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
9Department of Hematology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea
10Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Seoul, Korea
11Division of Hematology and Medical Oncology, Department of Internal Medicine, Daegu Fatima Hospital Cancer Center, Daegu, Korea
12Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Corresponding author:
Su-Jin Koh
Tel: 82-52-250-8978
Email: sujinkoh@uuh.ulsan.kr
Received: 11 February 2025 • Accepted: 9 April 2025
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Abstract
Purpose
This study aimed to explore the practices, perceptions, and barriers related to specialty palliative care (SPC) referrals among oncologists in Korea, highlighting the clinical implications of early integration.
Materials and Methods
A cross-sectional online survey targeting board-certified hemato-oncology specialists was conducted between August 1–25, 2024. The survey assessed referral practices, attitudes toward early SPC integration, referral criteria, barriers, and institutional characteristics.
Results
A total of 227 oncologists participated (response rate: 36.7%). Among them, 68.7% reported frequent SPC referrals, with higher referral rates observed among younger physicians, those in tertiary hospitals, and institutions with in-house SPC teams (p<0.001). Although 74.9% supported early SPC integration, referrals were often inconsistently timed, frequently occurring after disease progression or at the discontinuation of chemotherapy. For time-based referrals, the most commonly endorsed triggers were disease progression despite palliative second-line treatment and a prognosis of expected mortality within 6–12 months. Need-based referral triggers such as patient or family requests (96.5%), psychological distress (89.9%), or uncontrolled symptoms (83.3%), were also widely endorsed. The major barriers to early SPC integration included patient and family resistance (70.0%) and limited availability of SPC teams (34.4%).
Conclusion
This study emphasizes the importance of systematic efforts to promote timely SPC integration in Korea, including education to raise patient awareness, improved referral systems, and enhanced infrastructure. The positive attitudes toward early SPC among oncologists reflect a growing recognition of its value, highlighting the need for strategies that align with international standards.
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