Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

Samira Beiranvand; Maryam Rassouli; Maryam Hazrati; Shahram Molavynejad; Suzanne Hojjat; Kourosh Zarea

doi:10.3389/fpsyg.2022.807621

Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer

Front Psychol. 2022 Mar 28:13:807621. doi: 10.3389/fpsyg.2022.807621. eCollection 2022.

Authors

Samira Beiranvand¹, Maryam Rassouli², Maryam Hazrati³, Shahram Molavynejad¹, Suzanne Hojjat^{4

5}, Kourosh Zarea¹

Affiliations

¹ Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
² Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
⁴ Department of Home-Based Palliative Care, ALA Cancer Prevention and Control Center (MACSA), Tehran, Iran.
⁵ French Institute of International Research and High Education, Paris, France.

Abstract

Introduction: Making appropriate plans for the provision of hospice care is considered a perceived need in the Iranian health system. The current study aimed to develop a model for establishing hospice care delivery system for the adult patients with cancer.

Materials and methods: This study is part (data of the third and fourth phases) of a larger study that has been done in four phases. This Health System Policy Research (HSPR) utilized a mixed qualitative-quantitative approach. At the first phase, a qualitative study was conducted which explained the care needs and the requirements for establishing this system from the stakeholders' perspective (directed content analysis). The second phase aimed to examine the current situation of hospice care delivery in Iran and identify and determine the similarities and differences among them in the selected countries (comparative study). At the third phase, the main areas of the model and the related indicators were extracted and prioritized by consulting with experts (Delphi survey). Then the model was formulated. At the fourth phase, the proposed model was validated and finalized in terms of importance, scientific acceptability, and feasibility.

Results: Based on the developed model the first and the most important step in establishing the hospice care delivery system is laying the groundwork in the health system which requires focusing on policymaking. It is necessary to establish hospice centers and implement public awareness raising programs, train, and supply expert manpower, strengthen family physician and referral process, formulate clinical guidelines, encourage the private sector and NGOs(Non-Governmental Organizations (NGOs).) to invest, develop end-of-life and hospice care service packages, and create quality care indicators. The proposed model had moderate feasibility.

Conclusion: This model was developed based on the current Iranian healthcare structure and the needs of terminally ill cancer patients. It can be used as a model tailored to the current state of the health system and community in Iran. It is suggested to use this model as a pilot at the regional level.

Keywords: Iran; cancer; health system; hospice; palliative care.