Healthcare professionals’ conceptualizations of palliative care and readiness for early integration: a cross‑sectional mixed‑methods survey in Finland

BACKGROUND: Early integration of palliative care for patients with advanced cancer is recommended by major organizations and guidelines, yet palliative care is often still perceived as end-of-life care or as incompatible with active oncological treatment. Such misconceptions may delay timely integration. METHODS: We conducted a cross-sectional mixed-methods survey among healthcare professionals in oncology services in Ostrobothnia, Finland. The survey included 15 Likert-scale statements (1-5) addressing perceived knowledge, values and role beliefs, and perceived capacity and support, plus one free-text question: "What is palliative care?". Likert responses were summarized descriptively and compared across demographic groups using non-parametric tests. Free-text responses were coded using a predefined framework of 25 themes derived from the WHO definition of palliative care and Finnish national quality recommendations, generating a binary concept-coverage score (0-25). Responses were also classified for an end-of-life/non-concurrent conceptualization ("non-concurrent framing"). Group differences in concept-coverage scores were tested using Mann-Whitney U. RESULTS: Ninety-six professionals completed the survey (response rate 88.1%); 95 responded to the free-text item. While participants strongly endorsed statements about palliative care benefits and values, endorsement was lower for perceived competence and lowest for resources and support. Nearly one-third of participants expressed a non-concurrent/end-of-life framing of palliative care in their free-text definition. Concept-coverage scores were significantly lower among participants with non-concurrent framing compared with those without, particularly framework categories related to practical factors and system-level drivers. CONCLUSION: The open-ended responses indicated variability in the conceptualization of palliative care, including descriptions consistent with an end-of-life or non-concurrent view. This pattern identifies a potential target for education and implementation aligned with national guidance and quality recommendations.