Palliative Care Stigma in Oncology: An Integrated Systematic Literature Review

Purpose To conduct an integrated systematic literature review to explore (1) the presence and impact of stigma surrounding palliative care (PC) in Oncology particularly related to the care of adults with advanced cancer and (2) how Oncology healthcare providers (OHCPs) may contribute and perpetuate PC stigma, a factor associated with the underutilization of PC. Methods A comprehensive search was conducted in four major databases using PRISMA guidelines. Thirty‐two articles met the inclusion criteria focused on the perspectives of PC by OHCPs who treat adults with advanced cancer. Guided by Goffman’s Theory of Stigma, articles were iteratively reviewed and stigma‐related themes were generated. Results Six major themes emerged defining the concept of Oncology PC stigma and were categorized into two groups, which Goffman labels as “stigmatized” and “stigmatizers.” Assumptions, fear, and discomfort are the three common perceptions OHCPs which drive their behaviors as the stigmatizers. Avoidance, undesired differentness, and negative association with the term “palliative care” are the three reoccurring behaviors and perceptions seen in adults with advanced‐stage cancer, who are the stigmatized. A novel conceptual framework is presented with these six major characteristics of Oncology PC stigma with their corresponding outcomes. Conclusion Societal stigma associated with PC in Oncology is pervasive and driven by behaviors and perceptions of not only patients and their families who are reluctant to use PC but OHCPs themselves. Findings underscore the need for interventions that address OHCP’s lack of understanding about how their own perceptions and behaviors may impact patient PC utilization and outcomes.