Developing an integrated model of community-based palliative care into the primary health care (PHC) for terminally ill cancer patients in Iran

Hojjat-Assari, Suzanne; Rassouli, Maryam; Madani, Maxwell; Heydari, Heshmatolah

doi:10.1186/s12904-021-00795-2

Cited by 12 publications

(10 citation statements)

References 44 publications

(50 reference statements)

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“…Therefore, the integration of services into this level of care is essential in developing a hospice care delivery system. Consistent with this study, Hojjat-Assari’s model, palliative care is provided at various levels of the health system ( Hojjat-Assari et al, 2021 ).…”

Section: Discussionmentioning

confidence: 63%

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Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

et al. 2022

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IntroductionMaking appropriate plans for the provision of hospice care is considered a perceived need in the Iranian health system. The current study aimed to develop a model for establishing hospice care delivery system for the adult patients with cancer.Materials and MethodsThis study is part (data of the third and fourth phases) of a larger study that has been done in four phases. This Health System Policy Research (HSPR) utilized a mixed qualitative-quantitative approach. At the first phase, a qualitative study was conducted which explained the care needs and the requirements for establishing this system from the stakeholders’ perspective (directed content analysis). The second phase aimed to examine the current situation of hospice care delivery in Iran and identify and determine the similarities and differences among them in the selected countries (comparative study). At the third phase, the main areas of the model and the related indicators were extracted and prioritized by consulting with experts (Delphi survey). Then the model was formulated. At the fourth phase, the proposed model was validated and finalized in terms of importance, scientific acceptability, and feasibility.ResultsBased on the developed model the first and the most important step in establishing the hospice care delivery system is laying the groundwork in the health system which requires focusing on policymaking. It is necessary to establish hospice centers and implement public awareness raising programs, train, and supply expert manpower, strengthen family physician and referral process, formulate clinical guidelines, encourage the private sector and NGOs(Non-Governmental Organizations (NGOs).) to invest, develop end-of-life and hospice care service packages, and create quality care indicators. The proposed model had moderate feasibility.ConclusionThis model was developed based on the current Iranian healthcare structure and the needs of terminally ill cancer patients. It can be used as a model tailored to the current state of the health system and community in Iran. It is suggested to use this model as a pilot at the regional level.

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Section: Discussionmentioning

confidence: 63%

“…This is a Health System Policy Research (HSPR) ( Hojjat-Assari et al, 2021 ) conducted using a sequential mixed method in 4 phases from February 2018 to July 2020. Figure 1 displays the phases of the study.…”

Section: Methodsmentioning

confidence: 99%

Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

et al. 2022

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“…In order to deliver effective palliative care, the patient’s family should be informed of the prognosis of the disease and incoming problems from the early days of the injury. One of the important factors that can improve the quality of services is to involve the patient’s family in planning the care program, during which they should receive the necessary training, where a mutual relationship should be formed between the patient’s family and the specialist from the time of diagnosis until the patient’s death [ 16 ]. In addition to providing comprehensive support to the patient during the disease course, the patient’s family should also become prepared for his/her death so that they can bear the grief easier [ 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Families and caregivers face many issues and problems during caring for SCI patients at home [ 15 ]. Due to various reasons such as the lack of educational, supervisory, and specialized systems, the management of patients with chronic diseases should inevitably pass from the in-hospital phase to home-based and in-society maintenance therapy, as one of the important pillars of the healthcare chain [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring caregivers’ perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study

Galehdar

Heydari

2023

BMC Prim. Care

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Background The incidence of spinal cord injury is increasing worldwide. Patients with spinal cord injury and their families face many difficulties during the disease course. Caregivers are more involved with these patients than anyone else, so recognizing patients’ care requirements based on caregivers’ opinions can facilitate care provision to these people. The purpose of this study was to explore caregivers’ perceptions of the community-based services requirements of patients with spinal cord injury. Methods This qualitative research was conducted in Iran from Apr 2021 to Dec 2022 using the conventional content analysis method. The participants in the study included family caregivers and providers of home care services to patients with spinal cord injury, who were selected by purposeful sampling. Data were collected by conducting 14 face-to-face interviews and analyzed based on the method proposed by Lundman and Graneheim. Results Data analysis led to the extraction of 815 primary codes, which were organized into two themes: community reintegration (with two categories, including the need to provide a suitable social platform and lifelong care) and palliative care (with two categories, including family conference and survival management). Conclusion Social facilities and infrastructure should be modified in a way that patients with spinal cord injury can appropriately benefit from community-based care services and an independent satisfactory life. Palliative care should be continuously provided from the time of lesion development until the patient’s death.

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“…According to studies, patients' families admitted to the ICU suffer psychological distress, which can negatively affect the family members and the patient [16]. Stressors for patients' families include invasive care, complex equipment, unfamiliar interventions, cardiopulmonary resuscitation before death, and losing the loved one in these units [17,18]. These families continuously try to adapt to critical conditions in the intensive care unit [19].…”

Section: Introductionmentioning

confidence: 99%

Effect of family-centered interventions on self-efficacy of family of patients with low consciousness admitted the intensive care units : A randomized controlled trial

Biranvand

Birjandi

Goudarzi

et al. 2023

JHNM

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Introduction: Families of patients with low consciousness have an important role in supporting them and should acquire the necessary capability for patient care. Objective: This study aimed to examine the effect of family-centered interventions on the self-efficacy of the families of patients admitted to the intensive care units. Materials and Methods: This research was a randomized clinical trial with a pretest-posttest design conducted in intensive care units of hospitals in Khorram abad City, Iran, in 2019-2020. Seventy family members of patients were selected by convenience sampling and were assigned to the intervention (n=28) and control (n=28) groups by stratified random blocks. The study data were collected through the self-efficacy questionnaire and Hospital Anxiety and Depression Scale. The intervention was carried out using a family-centered model. The collected data were analyzed using the statistical tests of the Chi-square, independent t-test, and paired t-test. Also, the generalized linear model was used to compare changes in self-efficacy scores of the two study groups after adjusting demographic, anxiety, and depression variables. Results: Data analysis showed that most samples were male (53.8%) with a mean age of 38.15±8.68 years. The results showed a significant difference in the mean scores of self-efficacy, anxiety, and depression between the intervention and control groups (P=0.001). The intervention significantly increased the Mean±SD of caregivers’ self-efficacy (40.14±14.35, P=0.001) in the intervention group. The results showed that the self-efficacy mean score of the intervention group was 36 scores higher than the caregivers’ self-efficacy of the control group (95% CI; 20.6-51.4, P=0.028). Conclusion: The participation of family members of patients with low consciousness in the care of the patients in the intensive care unit has an effective role in the self-efficacy of caregivers of these patients.

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Developing an integrated model of community-based palliative care into the primary health care (PHC) for terminally ill cancer patients in Iran

Cited by 12 publications

References 44 publications

Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

Exploring caregivers’ perceptions of community-based service requirements of patients with spinal cord injury: a qualitative study

Effect of family-centered interventions on self-efficacy of family of patients with low consciousness admitted the intensive care units : A randomized controlled trial

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