Analysis of Hungarian oncologists’, general practitioners’, and palliative medicine specialists’ attitudes toward patient transition in palliative care with narrative psychology

Background: Research proves the increasing number of benefits of the early introduction of palliative care in parallel with active oncological treatment. Despite growing global awareness of palliative care, referrals are often hindered not by a lack of medical knowledge but by physicians’ attitudes and underlying emotions. The present study examined the similarities and differences in the attitudes of oncologists, general practitioners, and palliative medicine specialists in Hungary regarding the patient transition in palliative care. The authors assume that by exploring and raising awareness of the differences, communication between professions can be facilitated, and thus the patient pathway for patients in advanced stages can be optimized. Methods: The study conducted three focus groups involving 29 doctors: 11 general practitioners (GPs), 8 oncologists, and 11 palliative medicine specialists. These conversations were analyzed using NarrCat, a computer application based on narrative psychology that classifies terms into predefined categories. This allowed us to quantify and compare the frequency of terms associated with emotions, activity, and compulsion across the three professional groups. Results: The analysis revealed distinct patterns in language use among the professions. Oncologists exhibited high levels of activity (2,235 expressions) and compulsion (193) but showed minimal use of emotional vocabulary (242), suggesting that oncologists feel obligated to care for advanced cancer patients, yet paired with emotional detachment. GPs demonstrated high passivity (2,005) and frequent use of emotional expression (1,416), with the majority being negative emotions (1,378), indicating feelings of helplessness. In contrast, palliative medicine physicians used a high number of activity-related terms (2,213), demonstrated elevated consciousness (2,770), and expressed a more balanced emotional response (2,103), indicating both emotional awareness and professional agency in their approach to patient care. Conclusions: The study found significant differences across nearly all tested indicators in the attitudes of the three Hungarian professional groups. Most palliative medicine physicians in the present study were originally trained as GPs or oncologists. The results of the present study indicate that specialized palliative care training significantly reduces the feeling of compulsion and passivity, while increasing cognition in the care of patients with advanced cancer. Furthermore, palliative care-trained people demonstrated significantly greater ability to experience and express emotions, such as empathy and sympathy towards their patients.