Abstract
Context
Lack of palliative care (PC) awareness is a barrier to its utilization in developing
contexts.
Objectives
To identify and understand strategies that changed awareness of the concepts and value
of palliative care in a multi-site quality improvement project in India.
Methods
The Palliative Care - Promoting Assessment and Improvement of the Cancer Experience
(PC-PAICE) evaluation team conducted 44 semi-structured interviews with clinician
and organization stakeholders at seven geographically dispersed sites. We used inductive
and deductive approaches in this secondary analysis to identify emerging themes.
Results
We identified the following strategies to improve awareness of concepts and value
of palliative care. Strategy 1: Educate medical trainees, staff, and the community
about palliative care and its concepts. Sub-strategies: Participate in community events.
Integrate PC concepts into early medical education. Standardize training for practitioners.
Strategy 2: Design and disseminate India-specific research to reinforce awareness
of the value of palliative care. Sub-strategies: Publish and use India-specific palliative
care research. Strategy 3: Facilitate communication between providers and departments
to improve awareness of palliative care services and its concepts. Sub-strategies:
Create referral frameworks and network with providers referring to palliative care
to change awareness of available services and palliative care concepts.
Conclusion
To increase palliative care utilization, program development can include community
and provider-focused efforts on awareness of the concepts and value of palliative
care. These three strategies held salience across sites representing diverse Indian
geographic and cultural settings; as such, they may be applicable to other contexts.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pain and Symptom ManagementAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
World Health Organization. Palliative care. Available at:https://www.who.int/news-room/fact-sheets/detail/palliative-care. Accessed August 5, 2020.
- The global state of palliative care—progress and challenges in cancer care.Ann Pall Med. 2014; 3
World Health Assembly. WHA67.19: strengthening of palliative care as a component of comprehensive care throughout the life course. 2014.
- Nations within a nation: variations in epidemiological transition across the states of India, 1990-2016 in the global burden of disease study.Lancet. 2017; 390: 2437-2460
- India's escalating burden of non-communicable diseases.Lancet. 2018; 6: 1262-1263
- Cancer statistics, 2020: report from national cancer registry programme, India.JCO Global Onc. 2020; 6: 1063-1075
- The burden of cancers and their variations across the states of India: the global burden of disease study 1990-2016.Lancet. 2018; 19: 1289-1306
- Profile of patients opting for palliative care in India.Indian J Palliat Care. 2017; 23: 451-455
- The current status of palliative care in India. In: Magrath I, eds. Cancer Control: Cancer Care in Emerging Health Systems.Brussels, Belgium: INCTR. 2015; : 57-62
- COVID-19 pandemic and limited palliative care response: “Lack of comfort care”.Anaesth Crit Care Pain Med. 2020; 39: 591
- Palliative care in India: current progress and future needs.Indian J Palliat Care. 2012; 18: 149-154
- Kerala, India: a regional community-based palliative care model.J Pain Symptom Manage. 2007; 33: 623-627
- Enabling factors for neighbourhood network in palliative care (NNPC).An Exploratory Study in Kozhikode District, Kerala2015: 1-44
- Deconstructing and assessing knowledge and awareness in public health research.Front Public Health. 2017; 5: 194
- Is the Kerala model of community-based palliative care operations sustainable? evidence from the field.Indian J Palliat Care. 2021; 27: 18-22
- A comparative study to assess the awareness of palliative care between urban and rural areas of Ernakulum district, Kerala, India.Indian J Palliat Care. 2009; 15: 122-126
- Evaluation of community-based palliative care services: perspectives from various stakeholders.Indian J Palliat Care. 2017; 23: 425-430
- Impact of health awareness campaign in improving the perception of the community about palliative care: a pre- and post-intervention Study in Rural Tamil Nadu.Indian J Palliat Care. 2016; 22: 467-476
- Awareness of palliative care among doctors of various departments in all four teaching medical colleges in a metropolitan city in Eastern India: a survey.J Educ Health Promot. 2015; 4: 20
Rao S. Lien collaborative progress in India. 2020. Available at: https://aphn.org/lien-collaborative-progress-in-india/. Accessed January 2, 2022.
Indian Association of Palliative Care. Newsletter. 2020. Available at: https://www.palliativecare.in/iapc-newsletter-february-2020/. Accessed January 2, 2022.
- Institute-based sustainable palliative care program: a unique initiative of “cancer treatment center program”.Indian J Palliat Care. 2019; 25: 485-486
Indian Association of Palliative Care. Cancer awareness and palliative care sensitization campaign. 2019. Available at: https://www.palliativecare.in/cancer-awareness-and-palliative-care-sensitization-campaign/. Accessed January 2, 2022.
- Palliative care research: Indian perspective.Indian J Palliat Care. 2014; 20: 167-168
- The palliative care—promoting access and improvement of the cancer experience (PC-PAICE) project in India: a multisite international quality improvement collaborative.J Pain Symptom Manage. 2021; 61: 190-197
- Barriers and facilitators of using quality improvement to foster locally initiated innovation in palliative care services in India.J Gen Intern Med. 2020; 36: 366-373
- Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science.Implement Sci. 2009; 4: 50
- The discovery of grounded theory: Strategies for qualitative research.Routledge, Piscataway2017
- ATLAS.ti [computer program]. 8th ed. Scientific Software Development, Lanham2019
- Research methods in anthropology: Qualitative and quantitative methods.AltaMira Press, 2002
Roller R, Lavrakas P. Applied qualitative research design: a total quality framework approach. 2015;241-244.
- Efficacy of the theory of planned behavior: a meta-analytic review.Br J Soc Psychol. 2001; 40: 471-499
- Expectancy-value theory of achievement motivation.Contemp Educ Psychol. 2000; 25: 68-81
- Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.Int J Qual Health Care. 2007; 19: 349-357
- Models of delivering palliative and end-of-life care in India.Curr Opin Support Palliat Care. 2013; 7: 216-222
- Public health research in India in the new millennium: a bibliometric analysis.Glob Health Action. 2015; 8: 275-276
- From cure to palliation: agreement, timing and decision making within the staff.Am J Hospice Palliat Med. 2007; 24: 366-370
- Transition from curative to palliative care in cancer.Indian J Palliat Care. 2011; 17: 1-5
- A timely referral to palliative care team improves quality of life.Indian J Palliat Care. 2011; 17: 14-16
Article info
Publication history
Published online: June 25, 2022
Accepted:
June 21,
2022
Identification
Copyright
Published by Elsevier Inc. on behalf of American Academy of Hospice and Palliative Medicine.
