Factors Associated with Choosing the Kerala Model of Palliative Care versus Standard Care among Indian Cancer Patients

Abstract

Patients who opt for the Kerala Model of Palliative Care (KMPC) report favorable psychological outcomes. Still, not all patients in Kerala prefer this treatment's approach. Hence, this study is aimed to examine the demographical, medical, pain, and psychological factors associated with cancer patients who choose the KMPC versus standard care (SC). Using a cross-sectional design and purposive sampling, 87 patients (SC = 40; KMPC = 47) residing in Kerala, India, responded to questionnaires on pain, anxiety, and depression, and quality of life (QoL). Data analysis was conducted using chi-squared and independent sample t-tests. Findings revealed that KMPC (vs. SC) patients had lower levels of education, were self-employed or homemakers, belonged to a middle or low socioeconomic status, received government aid or were financially self-supported, and were diagnosed for less than 1 year or less than 5 years. KMPC patients reported higher levels of pain, lower levels of anxiety and depression, better overall total QoL, physical health, social health, functionality capacity, and emotional health. These findings suggest the need for community awareness programs regarding the benefits of opting for the KMPC. Patients who chose KMPC reported higher levels of pain than SC patients, highlighting the need for the KMPC to improve its approach to pain management.

TechCare: Transformative Innovations in Addressing the Psychosocial Challenges of Cancer Care in Kerala, India

“…Palliative care units, home visit programs, and initiatives to make pain relief more accessible reflect a compassionate and patient-centric approach. 22 This approach not only provides accessibility and affordable care, but tackles the issue of cancer stigma by encouraging societal participation in its activities.…”

“…20 Looking at the challenges of health care accessibility and affordability, geographical barriers and economic disparities often lead to delays in seeking medical assistance and adversely affect primary, palliative, and survivorship care. [21][22][23] Sixty-nine percent of India's population lives in rural areas, where access to tertiary cancer centers is severely limited by issues with accommodations, long travel distances, and linguistic and cultural barriers. 24 Cancer care in India is relatively less expensive compared with developed nations like the United States, but most Indian patients face high costs relative to their annual income.…”

The Future of Palliative Treatment in India: A Review

“…There are still some glaring deficiencies that involvement of the home-care services may decrease the involvement of the professional health workers. The unprofessional workforce can risk the treatment of the patient and also risk the research by non-documentation of the treatment [ 19 ].…”

Exploring Holistic Cancer Care and Survivorship in India Through the Kerala Model of Palliative Care

“…This Arogyakeralam (translated as "Healthy Kerala") project is based on a unique palliative care policy issued by the Government of Kerala in 2008, under India's National Rural Health Mission and in collaboration with the World Health Organization. [19][20][21][22] This model, popularly known as the Kerala model of palliative care (KMPC), follows a 3-tier care delivery system, including primary, secondary, and tertiary levels. The tertiary level focuses on research and training, whereas the secondary level includes doctors providing specialized care to patients in district or taluk hospitals.…”

“…It is an integrated model of care unlike or different from traditional hospice care and is available from diagnosis through survivorship to all chronically ill patients needing palliative care. This Arogyakeralam (translated as “Healthy Kerala”) project is based on a unique palliative care policy issued by the Government of Kerala in 2008, under India's National Rural Health Mission and in collaboration with the World Health Organization 19-22 . This model, popularly known as the Kerala model of palliative care (KMPC), follows a 3-tier care delivery system, including primary, secondary, and tertiary levels.…”