Barriers and benefits of model development for integration of palliative care for cancer patients in a developing country: A qualitative study

Abstract

Aim The aim of the study was to identify barriers and benefits in establishing a model for integration of palliative care of cancer patients in daily clinical practice in tertiary health institutions. Methods This was a qualitative design study using in‐depth interviews with four stakeholders and focus group discussions with 19 nurse managers using purposive sampling to select the participants, utilizing interpretive paradigm method. Need was ascertained for a model that would guide nursing care for cancer patients. Results Barriers identified in relation to integrating palliative care in daily clinical practice included lack of hospital policies about palliative care activities, cultural influences, denial or rejection of diagnosis by patients, inappropriate attitude of health care workers, patients failing to keep check‐up appointments and financial implications of setting up a dedicated palliative care team. Benefits of the model were twofold: hospital outcomes and patients/family outcomes. Conclusions Quality care for cancer patients/families calls for the adoption of clearly set out principles of palliative care as an integral component of daily practice. Challenges to implementation of palliative care services in hospitals can be overcome by establishing workable policies and allocating adequate funds for palliative care activities.

Benefits of integrating palliative care: a qualitative exploration of the perspectives of palliative care providers in a tertiary health facility in Ghana

“…The result aligns with previous studies that have reported that integration of PC enhances preparations towards the EoL. 20,34 For example, the result is consistent with the findings of Ndiok and Ncama 20 whose study revealed that integrating PC promoted meaningful EoL (i.e. preparing for the EoL).…”

“…The result corroborates the findings of earlier studies that have found interdisciplinary communication between primary healthcare providers and the PC team to have improved as a result of integrating care. 20,21…”

“…The study also revealed that integrating PC had the potential to strengthen the staff capacity to provide PC services. Ndiok and Ncama 20 have also reported that PC integration provides an opportunity to have well-trained nurses in PC. In the context of this study, the findings could be explained by the point that, there is currently some level of inclusion of PC in the preservice curriculum of medical students.…”

“…Prior studies that examined the benefits of integrating PC served guided the design of the interview guide. 20,21 These studies informed the main questions and probing questions. Participants were provided with an information sheet that detailed the aims, procedure, potential benefits and discomforts from participating in the study, the duration of the study, as well as their right to anonymity, confidentiality, privacy and autonomy to withdraw from the study.…”

Barriers to the integration of palliative care in Ghana: evidence from a tertiary health facility

“…This finding mirrors that of several studies. 21–23 The present finding reveals that patients who ascribed their disease to spiritual causation often reported late for palliation. A plausible explanation for this could be that patients with poor knowledge and wrong perceptions about PC would want to assume a state of denial and explore all other options available to them before considering PC.…”