Abstract
AimTo investigate the barriers to home‐based palliative care for cancer patients from professional caregivers' experiences.DesignA qualitative study.MethodThis is a descriptive‐qualitative study carried out in the community‐based care. Twenty‐three participants took part in this study. Data were collected through semi‐structured interviews.ResultsData analysis led to the identification of three category of barriers including the lack of instructions (the lack of clinical practice guidelines, the ambiguity of tariffs and the lack of insurance coverage), family desperation (family views of prognosis, distrust and poverty) and lack of professionalism (limited knowledge, the use of amateur nurses and siloed care). Developing a care protocol and providing resources support contribute to the development of home‐based palliative care. Moreover, the education of families and training courses for nurses must be fostered.
Highlights
Cancer is the leading cause of death worldwide (Bray et al, 2018)
Data analysis from this study has identified barriers to the development of home-based palliative care services are the lack of clinical practice guidelines, family desperation and lack of professionalism at the point of care
This finding is in line with the findings reported by Bowman, Twohig, and Meier (2019), who described the ambiguity of the application of national standards to home care plans as one of the barriers to home-based palliative care (Bowman et al, 2019)
Summary
Cancer is the leading cause of death worldwide (Bray et al, 2018). Estimations suggest that in 2018, approximately 18.1 million new cancer cases and 9.6 million cancer deaths were recorded in the world (Ferlay et al, 2019). Between “2008–2030,” in low- and middle-income countries, the number of new cases of cancer is expected to increase by 80% (Bray, Jemal, Grey, Ferlay, & Forman, 2012). There are currently no systematic structures for providing palliative care in Iran and only about 5–6 centres are active These sites provide palliative care in hospital and home care models. Several barriers to providing palliative care in Iran include the following: the lack of a defined structure for palliative care in the healthcare system, the lack of a defined job position for palliative care providers and the absence of serious training on palliative care in the formal curriculum of medical universities (Mojen, 2017); literature exploring cancer patient's wishes regarding end-of-life care shows that many have a preference for home-based care. Despite this, few cancer patients die at home; most end-of-life care is provided in hospital settings (Arnold, Finucane, & Oxenham, 2015).
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