67 Background: A major misperception of palliative care (PC) is that it is only for people who are about to die. We recently identified this misperception as a barrier to PC in metastatic non-small cell lung cancer (mNSCLC) patients, patients who should all receive early PC per guidelines. The goal of this study was to assess patient characteristics associated with misperceptions about PC and to elicit patient perspectives on how to address them. Methods: We conducted a mixed-methods study of mNSCLC patients on immunotherapy or chemo-immunotherapy. A survey assessed sociodemographics, health literacy, and PC misperceptions. Semi-structured interviews queried perceptions of PC, experiences discussing PC with providers, and reactions to our institutional definition of PC. Qualitative data from interviews were analyzed using directed content analysis approach. Results: Sixty patients (Mean age = 63, 40% male; 18% African American, 45% inadequate health literacy) completed the survey. Twelve of the survey participants (Mean age = 65, 50% male, 25% African American, 67% inadequate health literacy; 50% with caregivers participating) also completed a semi-structured interview. Quantitative survey results showed equating PC with death and/or hospice did not differ based on gender, health literacy, rural vs. urban residence, or time since diagnosis (p’s > .05). Qualitative results showed patients and caregivers consistently associated PC with death (e.g., “the next step to the graveyard”) and hospice. Though some patients noted differences between our institution’s definition of PC and their perceptions (e.g., “delivered at any stage”), the definition did not increase interest and sometimes reinforced misperceptions (e.g., “See, that's a death spiral”). To address misconceptions, patients and caregivers suggested distinguishing PC from end of life and hospice, presenting it positively, and discussing it early into treatment. Conclusions: Lung cancer patients may associate PC with death even if they have adequate health literacy. Commonly used definitions of PC may not quell patient fears. PC needs to be presented as a positive service to patients early into treatment.
PSYCHOBIOLOGICAL, CLINICAL, AND SOCIOCULTURAL FACTORS THAT INFLUENCE AFRICAN AMERICAN WOMEN TO SEEK TREATMENT FOR INFERTILITY: A MIXED METHODS STUDY
