The quality of palliative care for patients with cancer in Indonesia

Contains fulltext : 135629.pdf (publisher's version ) (Open Access)In this thesis, four aspects of advanced cancer care in Indonesia have been studied: (1) The identification of problems and needs of patients with advanced cancer in Indonesian hospitals, with a comparison to a comparable group of patients in the Netherlands. (2) Assessment whether the problems of hospitalised patients with cancer in Indonesia were addressed and by whom. (3) The identification of the kind of family caregivers’ involvement in caring for patients with cancer during hospitalisation and the factors that influence their quality of life. (4) Face-validation of quality indicators for the organisation of palliative care in hospitals in Indonesia. We found that in Indonesia, financial problems were most prevalent (72 to 79%) in patients with cancer. The prevalence of most physical problems, except fatigue, was similar in the Dutch and in the Indonesian study group. Psychological problems appeared more often in the Dutch study population (50 to 90%) than in the Indonesian one (20 to 50%). For almost all problems, respondents in Indonesia needed more professional attention. The families appeared strongly involved in addressing patients’ symptoms and issues during hospitalisation. Very often, only the family was involved in addressing financial, autonomy, psychological, and social issues, and not the professionals. The doctors focused mainly on physical symptoms, while nurses also took care of other disease-related symptoms and issues. Being involved in addressing the patient’s psychological issues, being younger, not being the spouse, and having no previous experience in caring for a hospitalized patient with cancer negatively influenced the quality of life of family caregivers. Three out four QIs for the organisation of palliative care developed for European countries (76 of 98 QIs) were considered face-valid and applicable for Indonesian hospitals too. Two new QIs were added and 22 QIs were not considered useful.Radboud Universiteit Nijmegen, 23 februari 2015Promotores : Vernooij-Dassen, M.J.F.J., Vissers, K.C.P. Co-promotor : Engels, Y.M.P