Expectations and barriers to the utilization of specialist palliative care services among persons living with cancer in Ghana: an exploratory qualitative study

Adwoa Bemah Boamah Mensah; Abena Agyekum Poku; Kofi Boamah Mensah; Joshua Okyere; Maurice Mikare; Felix Apiribu; Emelia Osei Boakye; Joe-Nat Clegg Lamptey

doi:10.1177/26323524231193042

Expectations and barriers to the utilization of specialist palliative care services among persons living with cancer in Ghana: an exploratory qualitative study

Palliat Care Soc Pract. 2023 Aug 28:17:26323524231193042. doi: 10.1177/26323524231193042. eCollection 2023.

Authors

Adwoa Bemah Boamah Mensah¹, Abena Agyekum Poku^{2

3}, Kofi Boamah Mensah⁴, Joshua Okyere², Maurice Mikare^{1

5}, Felix Apiribu¹, Emelia Osei Boakye⁶, Joe-Nat Clegg Lamptey⁷

Affiliations

¹ Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
² Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
³ Directorate of Accident and Emergency, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁴ Department of Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana.
⁵ Nursing and Midwifery Training College - Zuarungu. Bolgatanga, Upper East Region.
⁶ Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
⁷ Department of Surgery, University of Ghana Medical School, University of Ghana, Legon, Accra, Ghana.

Abstract

Background: The need for palliative care among patients living with cancer is increasing globally. This need is far greater in resource-constrained settings like Ghana where there is a high unmet need for palliative care services. Consequently, there are lapses in the current palliative care regime, thus, resulting in suboptimal utilization.

Objective: The study aims to explore patients living with cancer's expectations of palliative care services and examine the barriers that impede palliative care utilization.

Design: Descriptive exploratory qualitative design.

Methods: A total of 15 patients living with cancer and receiving treatment in a tertiary health facility were purposively sampled to participate in this study. Semi-structured interviews were conducted. The data were transcribed and inductively analysed following Collaizi's qualitative analysis framework.

Results: From the analysis, the findings were grouped under two main categories: perceived expectations and barriers to utilizing palliative care. The participants expected to receive meaningful communication about their condition and prognosis; they also expected to be actively involved in palliative care decision-making. Regarding the barriers, the following themes emerged: financial constraints, unfavourable health appointment schedules, problems with the distance to the health facility, poor referral and follow-up from oncology specialists and being unaware of the availability of palliative care services.

Conclusion: In conclusion, there is a need to actively involve patients and their families in all decision-making along the continuum of palliative care service delivery. The study underscores the need for Ghana to implement an integration of palliative care services in primary healthcare facilities to avert the challenges that distance to tertiary healthcare facilities poses to palliative care utilization. Service providers must implement awareness programmes to enable patients to better comprehend palliative care services.

Keywords: cancer; healthcare services; palliative care; qualitative research; utilization.