Holistic Assessment of Community Palliative Care Needs Among Palestinian Cancer Patients

Abstract

Background: Palliative care focuses on improving the quality of life of terminally ill patients and their families. Objectives: This cross-sectional study aims to assess the level of community palliative care among terminally ill Palestinian cancer patients and the needs of their families in the West-Bank and Gaza strip. Methodology: A cross-sectional survey was conducted among cancer patients. Patients were recruited through five hospitals that provide cancer care in the West Bank and Gaza Strip (Al-Hussein Hospital, Beit Jala; Augusta Victoria Hospital, Jerusalem; Istishari Arab Hospital, Ramallah; European Hospital and Abd Al-Aziz Al-Rantisi Hospital; Gaza). Data were collected using an interview-based questionnaire. The questionnaire focused on assessment of physical, psychosocial, emotional, and spiritual components of palliative care. In addition, the questionnaire assessed caregiver’s needs. Results: A total of 238 patients were interviewed. The mean age of the participants was 53.8±15 years. The most common types of cancer among patients were breast cancer (51 [21.4%]) and colorectal cancer (33 [13.9%]). Fifty percent of the patients had their children as their primary caregivers. Overall, the majority of the patients had good psychosocial, spiritual, and emotional scores. On the other hand, >80% had moderate to poor physical functioning scores. Psychosocial and emotional scores decreased significantly as the disease progressed. More than 33% of the patients reported that their caregivers were in need of financial, legal, and work-related support. In addition, other commonly reported unmet needs included support in understanding what to expect in the future and dealing with the feelings and worries of the patient. Conclusions: Cancer patients suffer mostly from their physical symptoms in addition to financial problems. On the other hand, assessment of the emotional, spiritual and psychological functioning of Palestinian patients indicates that the strength of religious beliefs and the support of the family and the friends in the Palestinian community had a great impact on the patients and help reduced the gap in palliative care services.