临床指南建议对晚期肺癌患者进行早期姑息治疗。在资源有限的农村和服务不足的社区肿瘤学实践中，需要肿瘤科医生的初级姑息治疗和专业姑息治疗来满足患者的姑息治疗需求。本研究的目的是描述社区肿瘤学临床医生的初级姑息治疗实践以及将专业姑息治疗纳入农村和服务不足社区的常规晚期肺癌治疗的观点。参与者是从肯塔基州 15 个主要农村社区肿瘤实践中招募的临床医生。参与者完成了一项关于他们的主要姑息治疗实践以及将专业姑息治疗纳入晚期肺癌治疗的知识、障碍和促进因素的一次性调查。47 名临床医生（30% 的肿瘤学家）参与了调查。大多数（72.3%）临床医生在农村县工作。超过 70% 的受访者表示经常询问患者症状和身体功能问题，而不到一半的受访者表示经常询问关键的预后问题。大约 30% 的人至少对姑息治疗抱有一种误解（例如，姑息治疗仅适用于那些停止癌症治疗的人）。临床医生报告的专业姑息治疗转诊的障碍包括担心转诊会给患者发送错误信息（77%）以及担心预约会给患者带来负担（53%）。值得注意的是，临床医生报告的最常见的协助者是要求转诊的患者（93.6%）。需要开展教育计划和外展工作，向社区肿瘤临床医生通报姑息治疗、授权患者请求转诊并满足患者的姑息治疗需求评估、文档和标准化推荐模板。© 2024。作者获得 Springer-Verlag GmbH 德国（Springer Nature 旗下公司）的独家许可。

Clinical guidelines recommend early palliative care for patients with advanced lung cancer. In rural and underserved community oncology practices with limited resources, both primary palliative care from an oncologist and specialty palliative care are needed to address patients' palliative care needs. The aim of this study is to describe community oncology clinicians' primary palliative care practices and perspectives on integrating specialty palliative care into routine advanced lung cancer treatment in rural and underserved communities.Participants were clinicians recruited from 15 predominantly rural community oncology practices in Kentucky. Participants completed a one-time survey regarding their primary palliative care practices and knowledge, barriers, and facilitators to integrating specialty palliative care into advanced-stage lung cancer treatment.Forty-seven clinicians (30% oncologists) participated. The majority (72.3%) of clinicians worked in a rural county. Over 70% reported routinely asking patients about symptom and physical function concerns, whereas less than half reported routinely asking about key prognostic concerns. Roughly 30% held at least one palliative care misconception (e.g., palliative care is for only those who are stopping cancer treatment). Clinician-reported barriers to specialty palliative care referrals included fear a referral would send the wrong message to patients (77%) and concern about burdening patients with appointments (53%). Notably, the most common clinician-reported facilitator was a patient asking for a referral (93.6%).Educational programs and outreach efforts are needed to inform community oncology clinicians about palliative care, empower patients to request referrals, and facilitate patients' palliative care needs assessment, documentation, and standardized referral templates.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.