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These strategies provide groundwork for developing system-wide best practice approaches to the presentation of palliative care referral.
It was found that the professionals in primary care would like more training and education about how to refer patients to specialist palliative care and how to deal with issues of death and dying.
Therefore, any attempt to facilitate appropriate and timely referral to specialist palliative care services should address misconceptions and concerns held by patients, family members, and health professionals.
FINDINGS The classification of patients, the perception of the palliative care service, the existence of different pathways of care for cancer and non-cancer patients, and the role of other specialist nurses all seem to influence the referral patterns of community health professionals.
Education about the tasks of palliative care should be separated from referral process, allowing time for gradual adjustment, and re-visiting discussion to enable patients and families to take some control in the process of transition.

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