The Perspective of Cancer Patients in Palliative Care on Unmet Needs: A Qualitative Synthesis Using Meta-Ethnography

Author:

Basile Ilaria12ORCID,Consolo Letteria13,Rusconi Daniele4,Arba Laura5,Rampichini Flavia6ORCID,Caraceni Augusto27,Lusignani Maura8

Affiliation:

1. Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy

2. High-Complexity Unit of Palliative Care, Pain Therapy and Rehabilitation, Foundation IRCCS, National Cancer Institute, Milan, Italy

3. Bachelor School of Nursing, Foundation IRCCS, National Cancer Institute, Milan, Italy

4. Urology Unit, Foundation, IRCCS, National Cancer Institute, Milan, Italy

5. Head and Neck Cancer and Rare Tumor Medical Oncology Unit, Foundation, IRCCS, National Cancer Institute, Milan, Italy

6. Library of the Central School of Medicine, University of Milan, Milan, Italy

7. University of Milan, Milan, Italy

8. Department of Biomedical Sciences for Health, Milan, Italy

Abstract

Background As cancer patients approach the end of life, their needs become more complex, increasing the demand for palliative care. Advanced-stage cancer patients encounter increasing unmet psychological, physical, autonomy, and communication needs, reflecting the difference between patients’ perceived requirements and the support from health care professionals. The objective of this study was to synthesize qualitative evidence on unmet needs in palliative cancer care among inpatient and outpatient adults. Methods We conducted a meta-ethnographic review according to Noblit and Hare’s framework and the operationalized guidelines developed by Sattar. The eMERGe Reporting Guidance was followed. A literature search was conducted in Cinahl, Embase, Medline, Scopus, Web of Science, PsycINFO and Google Scholar for gray literature. For all the studies, direct quotes from the participants and authors’ results were identified, coded and analyzed in NVivo 1.7.1 and extracted as I and II order constructs from which higher third-order themes originated. Results Eight studies were included. Four new themes emerged, representing areas where palliative cancer care patients expressed a need for help: the need for comprehensive, patient-centered care, the need for maintaining a sense of autonomy and dignity, the need for attentive support to patients’ soul and the need for accessible and timely care. Conclusions Palliative care patients require a secure, suffering-free end-of-life journey with informed decision-making and team support. Ensuring continuity of care, validating their suffering, and allocating sufficient time are crucial aspects of care. This involves maintaining a consistent care plan, respecting patients’ emotions and experiences, and providing services tailored to individual needs.

Publisher

SAGE Publications

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