Considerations for Fostering Palliative Care Awareness in Developing Contexts: Strategies From Locally Initiated Projects in India

Nainwant Singh; Karleen F Giannitrapani; Aanchal Satija; Archana Ganesh; Raziel Gamboa; Soraya Fereydooni; Tayler Hennings; Shivani Chandrashekaran; Odette Spruijt; Sushma Bhatnagar; Karl A Lorenz

doi:10.1016/j.jpainsymman.2022.06.011

Considerations for Fostering Palliative Care Awareness in Developing Contexts: Strategies From Locally Initiated Projects in India

J Pain Symptom Manage. 2022 Oct;64(4):370-376. doi: 10.1016/j.jpainsymman.2022.06.011. Epub 2022 Jun 25.

Affiliations

¹ Division of Primary Care and Population Health (N.S., K.F.G., T.H., K.A.L.), Stanford University School of Medicine, Palo Alto, California, USA; VA HS R&D Center for Innovation to Implementation (Ci2i) (N.S. K.F.G., R.G., K.A.L.), Menlo Park, California, USA. Electronic address: nainwant@stanford.edu.
² Division of Primary Care and Population Health (N.S., K.F.G., T.H., K.A.L.), Stanford University School of Medicine, Palo Alto, California, USA; VA HS R&D Center for Innovation to Implementation (Ci2i) (N.S. K.F.G., R.G., K.A.L.), Menlo Park, California, USA.
³ Department of Onco-Anaesthesia and Palliative Medicine (A.S., A.G., S.B.), Dr. B. R. Ambedkar, IRCH, AIIMS, New Delhi, India.
⁴ VA HS R&D Center for Innovation to Implementation (Ci2i) (N.S. K.F.G., R.G., K.A.L.), Menlo Park, California, USA.
⁵ Yale University School of Medicine (S.F.), New Haven, Connecticut, USA.
⁶ Division of Primary Care and Population Health (N.S., K.F.G., T.H., K.A.L.), Stanford University School of Medicine, Palo Alto, California, USA.
⁷ Duke University School of Medicine (S.C.), Durham, North Carolina, USA.
⁸ Peter MacCallum Cancer Center (O.S.), University of Melbourne, Melbourne, VIC, Australia.

PMID: 35764200
DOI: 10.1016/j.jpainsymman.2022.06.011

Abstract

Context: Lack of palliative care (PC) awareness is a barrier to its utilization in developing contexts.

Objectives: To identify and understand strategies that changed awareness of the concepts and value of palliative care in a multi-site quality improvement project in India.

Methods: The Palliative Care - Promoting Assessment and Improvement of the Cancer Experience (PC-PAICE) evaluation team conducted 44 semi-structured interviews with clinician and organization stakeholders at seven geographically dispersed sites. We used inductive and deductive approaches in this secondary analysis to identify emerging themes.

Results: We identified the following strategies to improve awareness of concepts and value of palliative care. Strategy 1: Educate medical trainees, staff, and the community about palliative care and its concepts. Sub-strategies: Participate in community events. Integrate PC concepts into early medical education. Standardize training for practitioners. Strategy 2: Design and disseminate India-specific research to reinforce awareness of the value of palliative care. Sub-strategies: Publish and use India-specific palliative care research. Strategy 3: Facilitate communication between providers and departments to improve awareness of palliative care services and its concepts. Sub-strategies: Create referral frameworks and network with providers referring to palliative care to change awareness of available services and palliative care concepts.

Conclusion: To increase palliative care utilization, program development can include community and provider-focused efforts on awareness of the concepts and value of palliative care. These three strategies held salience across sites representing diverse Indian geographic and cultural settings; as such, they may be applicable to other contexts.

Keywords: India; awareness; palliative care; research; value.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Hospice and Palliative Care Nursing*
Humans
India
Neoplasms*
Palliative Care
Quality Improvement