Abstract
BackgroundAccording to the World Health Organization, palliative care is one of the main components of healthcare. As the incidence of cancer is increasing in the world, home-based palliative care can be beneficial for many patients. This study was designed to explore health care providers’ perceptions about home-based palliative care in terminally ill cancer patients.MethodsThis qualitative study was carried out using the conventional content analysis from October 2016 to September 2018 in Iran. Participants were home care providers who were selected using purposive sampling. The data were collected through 18 individual interviews, and a focus group meeting. Data were analyzed based on the method proposed by Lundman and Graneheim.Resultsfrom the data analysis, 511 initial codes were extracted, which were categorized into the two main categories of challenges and opportunities for home-based palliative care and 10 subcategories. The subcategories of challenges included deficiencies in inter-sectoral and inter-professional cooperation, lack of infrastructures for end-of-life care, challenges related to the management of death, challenges of transferring patients to home, providing non-academic palliative care, lack of political commitment of the government and Spiritual vacuum. The category of opportunities included subcategories of cost-effectiveness, moving towards socializing health, and structure of the health system.ConclusionsHome-based palliative care requires government and health system support. Structural and process modification in the healthcare can provide conditions in which terminally ill cancer patients receive appropriate care in home and experience death with dignity through support of family, friends and healthcare.
Highlights
According to the World Health Organization, palliative care is one of the main components of healthcare
Home-based palliative care increases satisfaction and quality of life in patients and their families and reduces the cost imposed on the health system and re-hospitalization [5,6,7,8,9]
Data analysis indicated that Iranian health system suffers from weaknesses in intersectoral and inter-professional collaboration in providing community-based health services, so that different health professions in most cases offer treatment or health promotion programs to patients without coordination with each other
Summary
This qualitative study was conducted using a conventional content analysis approach from October 2016 to September, 2018. A focus group discussion was held to enrich individual interviews and promote rigor of collected data. The investigator visited a charity institution providing home-based palliative care to patients with advanced cancer in order to have access to the potential participants. First interview was conducted with professionals involved in home-based palliative care. Data collection continued until data saturation achieved, and the participants did not provide new information and no new data obtained from the interviews [15]. A general question was asked, “What is your experience of home-based palliative care?” The researcher directed the interviews towards achieving the objectives of the study through probing questions. Ethical considerations Objectives and methods of the study were explained to all participants They were assured about anonymity and confidentiality of collected data and audio files. The study was approved by the Ethics Committee of Lorestan University of Medical Sciences: the ethics code of LUMS.REC.1394.57
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