Cancer Care in the Community Setting: A Mixed Method Study
DOI:
https://doi.org/10.33755/jkk.v11i1.786Keywords:
Cancer Care, Community-Based Care, Mixed Method, Palliative, Patient CareAbstract
Aims: This study evaluated palliative care services in Indonesia, focusing on proposing a community-based model to enhance cancer care.
Method: A mixed-method approach was employed, involving quantitative analysis of 200 patients’ personal and treatment factors and qualitative insights from 21 stakeholders to FGDs and in-depth interviews.
Results: The qualitative results highlight five themes: 1) illness as a subjective and culturally influenced concept, 2) family’s role in treatment decision-making, 3) perceptions of healing through multiple treatment modalities, 4) finding positive meaning in illness, and 5) hopes and aspirations for recovery. The quantitative results show that 55.5% of patients had inadequate knowledge, with 69.5% preferring modern therapy. A significant relationship was found between knowledge, perception, and treatment options, while no significant correlation was observed with self-confidence or diagnosis date.
Conclusion: An integrated community-based palliative care model tailored to Indonesia’s healthcare system is proposed to improve the quality of life for cancer patients.
References
World Health Organization. Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners, implementers and managers. 2018;
Riskesdas K. Hasil utama riset kesehata dasar (RISKESDAS). J Phys A Math Theor. 2018;44(8):1–200.
Eng V, Sudoyo AW, Nuhonni SA, Hendrianto K. Indonesia’s Unique Social System as Key to Successful Implementation of Community-and Home-Based Palliative Care. JCO Glob Oncol. 2023;9.
Reid EA, Kovalerchik O, Jubanyik K, Brown S, Hersey D, Grant L. Is palliative care cost-effective in low-income and middle-income countries? A mixed-methods systematic review. BMJ Support Palliat Care. 2019 Jun;9(2):120–9. https://doi.org/10.1136/bmjspcare-2018-001499
Van Beek K, Woitha K, Ahmed N, Menten J, Jaspers B, Engels Y, et al. Comparison of legislation, regulations and national health strategies for palliative care in seven European countries (Results from the Europall Research Group): a descriptive study. BMC Health Serv Res. 2013 Jul 17;13:275. https://doi.org/10.1186/1472-6963-13-275 PMID: 23866928
Fraser BA, Powell RA, Mwangi-Powell FN, Namisango E, Hannon B, Zimmermann C, et al. Palliative Care Development in Africa: Lessons From Uganda and Kenya. J Glob Oncol. 2018 Sep;4:1–10. https://doi.org/10.1200/ JGO.2017.010090 PMID: 30241205
Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 2018 Nov;6(11):e1196–252. https://doi.org/10.1016/S2214-109X(18)30386-3 PMID: 30196093
Dewi LKM, Gatellier L, Sabapathy K, Pramesh CS, Dai M, Huong TT, et al. An Asian Perspective of the Management of COVID-19: the Asian National Cancer Centers Alliance Led Regional Comparison. Asian Pacific Journal of Cancer Care. 2020 Aug 24;5(S1):27–42. https://doi.org/10. 31557/apjcc.2020.5.S1.27-42
Eng V, Sudoyo AW, Nuhonni SA, Hendrianto K. Indonesia’s Unique Social System as Key to Successful Implementation of Community- and Home-Based Palliative Care. JCO Glob Oncol. 2023 Jun;(9). https://doi.org/ 10.1200/GO.22.00290
Putranto R, Mudjaddid E, Shatri H, Adli M, Martina D. Development and challenges of palliative care in Indonesia: role of psychosomatic medicine. Biopsychosoc Med. 2017;11:1–5.
Frey R, Balmer D. The challenges for health professionals delivering palliative care in the community during the COVID-19 pandemic: An integrative review. Palliat Support Care. 2024 Aug 27;22(4):827–39. https://doi.org/10.1017/S1478951523000275
Effendy C, Silva JFDS, Padmawati RS. Identifying palliative care needs of patients with non-communicable diseases in Indonesia using the SPICT tool: a descriptive cross-sectional study. BMC Palliat Care. 2022 Jan 24;21(1):13. https://doi.org/10.1186/s12904-021-00881-5 PMID: 35073869
Doyle D, Hanks G, MacDonald N. Oxford textbook of palliative medicine. 2003;
Sánchez-Cárdenas MA, Tibaquirá CAN, Mantilla-Manosalva N, Fonseca DA, Morales AM, Delgado MXL. Palliative care education in undergraduate medical and nursing programs in Colombia: a cross-sectional analysis. BMC Palliat Care. 2024 Jun 13;23(1):149. https://doi.org/10.1186/s12904-024-01477-5
Elayaperumal S, Venugopal V, Dongre AR, Kumar S. Process of Developing Palliative Care Curriculum for Training Medical Interns in a Tertiary Care Teaching Hospital in Puducherry, India. Indian J Palliat Care. 2021;27(2):269–74. https://doi.org/10.25259/IJPC_349_20 PMID: 34511795
Luxon L. Infrastructure - the key to healthcare improvement. Future Hosp J. 2015 Feb;2(1):4–7. https://doi.org/10.7861/futurehosp.2-1-4 PMID: 31098066
Matthys M, Deforche B, Deliens L, Cohen J, Beernaert K, Van Brussel L, et al. Public Awareness Campaigns on Palliative Care: Applying a Multidimensional Model to Understand the Reception by the General Public. Qual Health Res. 2024 Dec 12; https://doi.org/10.1177/10497323241300911
Chapman AL, Hadfield M, Chapman CJ. Qualitative research in healthcare: an introduction to grounded theory using thematic analysis. Journal of the Royal College of Physicians of Edinburgh. 2015;45(3):201–5.
Kemenkes. Pedoman Teknis Pelayanan Paliatif Kanker. Jakarta: Kementrian Kesehatan Republik Indonesia. 2013;
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Mar 14;395(10227):912–20. https://doi.org/10.1016/S0140-6736(20)30460-8 PMID: 32112714
Ministry of Health. Pedoman Teknis Pelayanan Paliatif Kanker. Jakarta: Kementerian Kesehatan RI. 2013;
World Health Organization. Cancer control: knowledge into action: WHO guide for effective programmes. Vol. 2. World Health Organization; 2007.
Kemenkes. Keputusan Menteri Kesehatan Republik Indonesia Nomor: 812/Menkes/Sk/Vii/2007 Tentang Kebijakan Perawatan Paliatif Menteri Kesehatan Republik Indonesia. 2007.
World Health Organization. Integrating palliative care and symptom relief into paediatrics: a WHO guide for health-care planners, implementers and managers. 2018;
Heyn LG, Løkkeberg ST, Ellington L, van Dulmen S, Eide H. Understanding the role of positive emotions in healthcare communication - A realist review. Nurs Open. 2023 Jun;10(6):3447–59. https://doi.org/10.1002/nop2.1604 PMID: 36611271
Wu H, Volker DL. Humanistic Nursing Theory: application to hospice and palliative care. J Adv Nurs. 2012 Feb 20;68(2):471–9. https://doi.org/10.1111/j.1365-2648.2011.05770.x
Salikhanov I, Katapodi MC, Kunirova G, Crape BL. Improving palliative care outcomes in remote and rural areas of LMICs through family caregivers: lessons from Kazakhstan. Front Public Health. 2023;11:1186107. https://doi.org/10.3389/fpubh.2023.1186107 PMID: 37601198
Ben-Arye E, Lopez G, Rassouli M, Ortiz M, Cramer H, Samuels N. Cross-Cultural Patient Counseling and Communication in the Integrative Medicine Setting: Respecting the Patient’s Health Belief Model of Care. Curr Psychiatry Rep. 2024 Aug;26(8):422–34. https://doi.org/10.1007/s11920-024-01515-2 PMID: 38884698.
