Rehabilitation in oncological palliative care, does it exist? A qualitative and multicentre study of healthcare professionals’ perceptions

Objective To investigate how health professionals working in palliative care services understand rehabilitation related to oncology palliative care in England and Brazil, according to different health system contexts. Design Qualitative study. Setting Hospices, hospitals, community-based palliative care centre, palliative care units, nursing care homes in different areas of Brazil and England. Participants Thirty-six nurses and occupational therapists experienced in providing palliative care interventions from England and Brazil. Interventions Individual interviews with open-ended questions. Main Measures Individual semi-structured, in-depth interviews, analysed using Braun and Clarke's reflexive thematic analysis. Results Professionals in England demonstrated a consolidated and integrated understanding of rehabilitation as part of palliative care, often supported by structured services such as hospices. In contrast, many Brazilian participants expressed uncertainty or perceived rehabilitation as incompatible with end-of-life care, reflecting conceptual misunderstandings, limited training and a lack of service infrastructure. The findings revealed divergence in how rehabilitation in palliative care is conceptualised and implemented in these countries. This divergence is reflected in structural, educational and cultural differences in how palliative care is organised and delivered. However, there is a growing recognition that rehabilitation and palliative care are not separate but complementary approaches. Conclusions The findings underscore the urgent need to clarify definitions, develop unified conceptual models and invest in policy and education to ensure that rehabilitation is no longer seen as contradictory to palliative goals, but as a complementary strategy to enhance quality of life in advanced cancer care.