Indian Journal of Palliative Care
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 ORIGINAL ARTICLE
Year : 2019  |  Volume : 25  |  Issue : 3  |  Page : 428--435

“End-of-life care is more than wound care”: Health-care providers' perceptions of psychological and interpersonal needs of patients with terminal cancer


1 Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
2 Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Poornima Bhola
Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru - 560 029, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPC.IJPC_26_19

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Aim: People diagnosed with cancer and in end-of-life care may have a range of needs. These needs may be inadequately expressed, recognized, or responded to by family members and health-care providers. The present study aimed at exploring health-care providers' perceptions of the interpersonal needs, psychological needs, and unfinished business among terminally ill cancer patients during the end-of-life care. Methods: The sample consisted of 11 health-care providers, including physicians, counselors, social workers, and nurses from the end-of-life care settings in Bengaluru, India. A cross-sectional qualitative design was used and involved semi-structured interviews and focus group discussions. Results: Thematic analysis identified themes related to health-care providers' perceptions of patients' prominent interpersonal needs, psychological needs, and expressions of “unfinished business” and their perspectives and experiences. There were three themes related to psychological needs and concerns: (i) experience and expression of negative emotions, (ii) mental health concerns, and (iii) confronting mortality. Three themes emerged in the domain of interpersonal connections: (i) support and closer connections with family, (ii) disconnection from family relationships, and (iii) building new connections at the hospice. Two themes were identified related to unfinished business: (i) types of unfinished business and (ii) addressing unfinished business. The findings also highlighted health-care providers' perspectives and experiences: (i) need for expanded end-of-life care training and (ii) experiences of emotional labor. Conclusions: The findings have implications for comprehensive training of health-care providers and for assessment, support, and care services in palliative care settings in India.






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