Palliative care needs assessments of adult cancer patients in home healthcare setting in Karachi from the perspective of patients and their caregivers : a qualitative approach

The aim of this study was to identify the palliative care needs of adult cancer patients in home healthcare settings in Karachi, from the perspective of adult cancer patients and their adult informal direct caregivers. Methodology: A qualitative descriptive study design was used for this study. The snowball sampling technique was used to recruit the study participants. In all, 23 participants (including adult cancer patients and their informal direct caregivers) participated in this study. The data was collected from the participants from January 29, 2017, to April 25, 2017, by using a semi-structured interview guide. These interviews were audio-recorded and transcribed verbatim. The data was coded and categorized manually. Results: Five major categories emerged from the content analysis of the interviews of the participants: (1) physical needs; (2) psycho-social needs; (3) religious needs; (4) financial needs; and (5) needs related to healthcare system. Some of the categories were further classified into sub-categories. This study revealed that the activities of daily living and activities of self-care of the patients were affected due to the disease and its treatment course. The findings indicated that the roles of the patients were altered due to the disease and its manifestations, and treatment and its side effects. The results disclosed that the majority of the patients experienced fear and anxiety and became socially isolated on account of the disease, its treatment, and its side effects. This study also uncovered the changes faced by the patients in performing their religious practices due to either the disease process or the course of therapy, along with the effects of these modified religious practices on the satisfaction level of the patients. Additionally, this study reported the financial challenges confronted by the participants and how they handled these challenges. The findings of this study also portrayed the recommendations made by the participants for enhancing the care processes within the healthcare system. Conclusion: This study established the need of providing contextual-based palliative care services to the cancer patients. It also highlighted the need for healthcare institutions to broaden the scope of palliative care services currently available to the patients. Concurrently, reform of the policies, the protocols, structure, and professionals / personnel can benefit the patients, their family members, healthcare professionals, personnel, and the healthcare organization itself