Palliative cancer care in Middle Eastern countries: accomplishments and challenges (original) (raw)
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Palliative Care in the Arab World
Cancer in the Arab World, 2022
Palliative Care is an essential component of comprehensive cancer care, yet it remains inaccessible to a large majority of patients diagnosed with cancer in Arab countries. This chapter covers the current status of palliative care in Arab countries, covering several key indicators of palliative care development, including policy, service, education, and opioid consumption. We describe some of the barriers to the integration of palliative care into healthcare systems and propose steps to support the growth of palliative care in the region.
Journal of Pain and Symptom Management, 2009
Palliative care development and services were reviewed in the region represented by the six members of the Middle East Cancer Consortium: Cyprus, Egypt, Israel, Jordan, the Palestinian Authority, and Turkey. The multimethod review synthesized evidence from ethnographic field visits to inpatient units, home care hospice teams and free-standing hospices, including interviews with hospice and palliative care clinicians, administrators, volunteers, policy makers and academic researchers. Public health data and relevant literature were collated together with internet-accessed information on services and health care systems. A total of 69 services were located; two country members have a history of relatively sustained development of hospice and palliative care, but provision across the Middle East Cancer Consortium region is highly variable at a local level. Considerable barriers to service development were identified in a region already struggling with many military and political conflicts. Key problems are a lack of secure funds and government support, inadequate professional training programs, opioid phobia in professionals and the public, and a lack of awareness and understanding of palliative care needs at public, government, and professional levels. Key areas for further attention were increasing national and international professional training and public education programs, improving opioid legislation and health care policies, negotiating for secure government or health insurance funding provision, raising awareness about the need for pediatric services and for patients with other illnesses, as well as for those with cancer, and working to integrate palliative care into mainstream health service provision and education. J Pain Symptom Manage 2009;37:287e296. Ó
International Palliative Care: Middle East Experience As a Model for Global Palliative Care
Clinics in Geriatric Medicine, 2015
With the global shortage of palliative care (PC) specialists, it has become clear that care for elderly people with life-limiting illness cannot be delivered primarily by geriatricians or PC practitioners. In a culture in which family ties run deep, the offer of PC from an outsider is likely to be met with suspicion and distrust. The family bond in the Middle East may be stronger than in Western countries, but in contrast the emotional response to terminal illness may push families to request futile treatments, and physicians to comply. When PC is well developed and well understood, it provides a viable alternative to such extreme terminal measures.
Palliative Care in the United Arab Emirates: A Nurse’s Perspectives
Journal of Palliative Care & Medicine, 2015
The enormous burden of life-threatening illnesses including cancer is associated with physical and psychosocial suffering explains the illustrious and desperate need for palliative care in developing countries. Despite the demonstrated and proven benefit of palliative care in developed countries , current provision of effective and well structured palliative care in developing countries including the United Arab Emirates (UAE) is at best very limited. Access to essential pain medicines in developing countries, particularly oral opioids, for pain control is extremely limited and far below the global mean. Cancer patients in the UAE are having major difficulties in accessing palliative care services due to the limited palliative care facilities and trained physicians and other palliative health support workers in this field. There is a general lack of national health policies policies that recognize palliative care as an essential component of the current health care system and there is inadequate training for both health care providers and the general public about palliative care. We recommend establishing palliative care program within a public health strategy as part of a national cancer control plan, as recommended by the World Health Organization (WHO), which offers the best approach for translating knowledge and skills into evidence-based, cost-effective interventions that can reach everyone in need of palliative care in the UAE.
Cultural Aspects of Palliative Cancer Care in Iran
Palliative Medicine and Hospice Care - Open Journal, 2017
Palliative care is a human need, which is essential for patients with chronic disorders such as cancer, and aims to prevent and relieve pain and improve the quality of life (QoL) of patients and their families. Since culture is an important factor in predicting health behavior, it can be effective in providing these services. Thus, this review study has been conducted to assess the cultural aspects of palliative care in Iran. The findings were classified and provided based on the definition of palliative care on three major topics including early diagnosis, during treatment and disease period, and finally death and later. In the beginning of diagnosis, the most important element of palliative care is informing the disease to the patient and family. Disclosure of the disease in Iran is not culturally possible. The most important cultural barrier is cancer stigma in Iran, which affects the related measures such as screening diagnosis. The most important challenge in the treatment is pain management, which overshadowed factors such as cultural beliefs. Despite the challenges in the diagnosis and treatment of patients, which make the care difficult, the religious and spiritual context of Iranian people in the death and bereavement, as well as the strong family connections, are considered as a strong point that is helpful in the process of passing from the stage. According to the statement of the Union for International Cancer Control in 2008 based on "a better attitude toward cancer by 2020 and removing misconceptions about the disease", the available cultural opportunities in the country can be considered as areas in need of strengthening. The negative attitudes and beliefs can be reformed by adopting strategies such as increasing the awareness of the community as the first strategy in changing the culture.
Developing a palliative care service model for Muslim Middle Eastern countries
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2014
Palliative Care (PC) was first introduced to Muslim Middle Eastern (MME) countries in 1992, but growth of PC has been slow and access to PC is still limited in the region. While most PC models have been developed in Western countries, MME societies have different cultural and religious values that are not incorporated in Western models. We conducted a qualitative study to look at these differences, in order to inform a culturally acceptable model of PC that meets the needs of MME patients and their families. We conducted semi-structured interviews of PC physicians and nurses with experience in both Western and MME countries. Participants were identified by snowball sampling. Interviews were transcribed and analyzed using a modified grounded-theory approach. We achieved conceptual saturation after 13 interviews. Participants identified four differences between PC practice in Western and MME countries including: cultural differences, legal and policy differences, stances on PC philoso...
Palliative care for cancer patients in Sudan: an overview
ecancermedicalscience, 2014
Sudan is facing an increasing number of cancer patients every year, and cancer is now among the top ten killer diseases in the country. The majority of cancer patients are diagnosed with an advanced type of cancer where curative treatment has little, if any, effect. The need for palliative care (PC) is urgent. In spite of this, there is no established programme for comprehensive cancer control in the country. In this article we review the state of PC services available for cancer patients. A PC service started in 2010 as an outpatient service at the main oncology centre in Sudan. With the help of international bodies, several training activities in PC were held. Currently the service includes an outpatient clinic, a nine-bed ward, and a limited home-care service. PC has started to reach two other hospitals in the country. Unfortunately, the need is still great; the services provided are not fully supported by the hospital administration. And even now, thousands of patients outside the cities of Khartoum and Medani have no access to oral morphine.