جودة حياة مرضى السرطان الفلسطينيين في غياب خدمات الرعاية التلطيفية
Date
2013-01-13
Authors
محمد حسين حماد خليف
MOHAMMAD HUSEIN HAMMAD KHLEIF
Journal Title
Journal ISSN
Volume Title
Publisher
AL-Quds University
جامعة القدس
جامعة القدس
Abstract
Background overall Quality of Life (QoL) is fundamental for both well and ill people. For
the cancer patients it is a vital issue in the presence of this devastating condition that
depletes all the resources on both the individual and community level. This study looked
into the cancer patients QoL at the most difficult times of their lives. Cancer is the second
leading cause of death in Palestine; 12.4% of all deaths (MOH, 2012). Most of the cases are
diagnosed in late stage (Husseini et al, 2009), and very low levels of pain control and
palliative care are available (AL-Sadeel Society website, 2012).
Methods The aim of this study is to assess QoL domains scores and symptoms experience
within the Palestinian culture. The study was carried out in the only three main settings
available for treatment of cancer in the West Bank of Palestine.
In-depth interviews with 10 cancer patients were done to reveal the uniqueness and any
special concerns for Palestinian patients. And a cross sectional design studied 323 patients
to reveal associated factors with QoL. The data collection tools were structured in-depthinterview
questions and the QoL assessment tool of the European Organization for
Research and Treatment of Cancer (EORTC QLQ C-30) to which socio demographic data
were added.
Findings Both qualitative and quantitative parts of this research were in harmony in
representing the poor health related QoL (41.8%) of the cancer patients. The predictors of
poor QoL were advanced stage of cancer (β= -0.3, p<0.001), poor economical condition
(β= 0.19, p=0.001), low educational level (β= 0.12, p=0.04), and long duration of treatment
(β= -0.11, p=0.04). As well, the generated qualitative themes supported these results; the
main expressed needs of the cancer patients were financial aid, pain management, fully
equipped healthcare facilities in their vicinity, availability of medications and qualified
staff, eradication of stigmatization, communication and psychosocial support, health
education, home nursing care, and palliative care.QoL functions were low and below half of the full function in most cases; physical
(48.5%), role (48.8%), emotional (46%), cognitive (60.5%), and social (50%). Moreover,
severe symptoms were experienced by cancer patients; fatigue (66.6%), pain (63%),insomnia (56.4%), appetite loss (45.3%), and financial difficulties (64.6%). These results
were lower than other studies in the region, denoting difficult conditions of Palestinian
patients with cancer.
Conclusion Palestinian cancer patients are suffering from quite difficult conditions. These
can be divided to two main streams; socio-economic factors of the patients, and inability of
the healthcare system to early detect, diagnose, treat, and provide professional support,
especially to advanced stages cancer patients.
So, and for better QoL, there is desperate need for integrating palliative care services into
the health care system in Palestine as quality improvement, cost-effective and economically
efficient measure, and develops social welfare system. As well as, there is a need for early
detection, and awareness and education for cancer patients and health care providers.
Description
Keywords
السياسات والاداره الصحية , Policies & Health Management