| BARRIERS | COMMENTS |
| Denial | Unrealistic expectations Family denial |
| Fear | Concern of physician abandonment Concern about “giving up” |
| Sense of duty | Family demands and wishes |
| Anger | Questioning whether the disease course could have been altered with an earlier diagnosis or different treatment choice |
| Hope | Belief in a miracle |
| Health literacy | Misunderstanding palliative care Communication barriers Language barriers |
| Young age of patient |
|
| Religious background |
|
| Cultural background | Mistrust of medical establishment Role of family members in decision-making & communication |