O-52 Necessity of spiritual care for end-stage cancer patients and their families in Iran: From the analysis of practice in a home-visit organisation in Isfahan

Abstract

Background In middle-income countries such as Iran, the development of palliative care for patients with end-stage cancer at home has not been prioritised. However, recently, some organisations in Iran try to develop home-visit services for end-stage cancer patients, including medical, nursing, psycho-social, and spiritual care. Aim To understand the example of particular needs and demands of palliative care and advance care planning for Iranians, practices of care for end-stage cancer patients at home were studied in Isfahan, Iran. Methods Analysis of semi-structured interview data with professional/volunteer workers, patients with end-stage cancer at home and their families (15 people in total, introduced by a local organisation). Results Patients and families considered the demands for spiritual care more important, rather than the physical/social needs assessed by professionals. Discussion For Muslim end-stage cancer patients, spiritual care based on religious belief should be considered to achieve a good quality of care, especially when cancer is culturally recognised as a punishment by God, and notification of cancer to the patients has not been widely accepted by patients’ families. One case, in which a volunteer worker supported the patient and his family till the burial, showed that the palliative care and advanced care planning for Muslim patients should include the planning for patients’ departure and grief care for the families. Conclusion Deeper analysis of the needs for spiritual care should be sought as well as medical, nursing, psycho-social needs, for advance care planning for Shia Muslim patients with end-stage cancer and their families.