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Challenges on the provision of palliative care for patients with cancer in low- and middle-income countries: a systematic review of reviews.
- Source :
- BMC Palliative Care; 4/22/2020, Vol. 19 Issue 1, p1-16, 16p
- Publication Year :
- 2020
-
Abstract
- Background: Despite the significant benefits of palliative care (PC) services for cancer patients, multiple challenges hinder the provision of PC services for these patients. Low- and middle-income countries (LMICs) are witnessing a sharp growth in the burden of non-communicable diseases. There is a significant gap between demand and supply of PC in LMICs in current health services. This review aims to synthesise evidence from previous reviews and deliver a more comprehensive mapping of the existing literature about personal, system, policy, and organisational challenges and possible facilitators on the provision of PC services for cancer patients in LMICs. Methods: A systematic review of reviews was performed following PRISMA guidelines. PubMed, EMBASE, SCOPUS, PsycINFO, Web of Sciences, CINAHL, and Cochrane Library databases were searched to identify review papers published between 2000 and 2018 that considered challenges and possible facilitators to PC provision. A modified socioecological model was used as a framework for analysing and summarising findings. Results: Fourteen reviews were included. The reviews varied in terms of aim, settings, and detail of the challenges and possible facilitators. The main challenges of personal and health care systems included knowledge deficits and misunderstandings from patients, families, the general public, and health care providers about PC; and inadequate number of trained workforce. Besides, limited physical infrastructure, insufficient drugs for symptom relief and lack of a comprehensive national plan for implementing PC were the core organisational and policy level challenges that were recognised. Furthermore, the main possible facilitators that were identified included provision of adequate training for health care providers and health education for patients, families and the general public to enhance their knowledge, beliefs, and attitudes to PC. Finally, involvement of policymakers and making drugs available for symptom relief should also be in place to improve the health care systems. Conclusions: Understanding challenges to the provision of PC for people with cancer could help in the development of a PC pathway in LMICs. This knowledge could be used as a guide to develop an intervention programme to improve PC. Political influence and support are also required to ensure the sustainability and the provision of high-quality PC. [ABSTRACT FROM AUTHOR]
- Subjects :
- CANCER patients
CINAHL database
CLINICAL competence
CONCEPTUAL structures
HEALTH education
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
PSYCHOLOGY information storage & retrieval systems
MEDICAL personnel
HEALTH policy
MEDLINE
ONLINE information services
PALLIATIVE treatment
SYSTEMATIC reviews
HEALTH literacy
MIDDLE-income countries
LOW-income countries
Subjects
Details
- Language :
- English
- ISSN :
- 1472684X
- Volume :
- 19
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Palliative Care
- Publication Type :
- Academic Journal
- Accession number :
- 142847868
- Full Text :
- https://doi.org/10.1186/s12904-020-00558-5