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LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 115

Problems and needs of patients in palliative care


Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Date of Submission26-Dec-2019
Date of Acceptance06-Jan-2020
Date of Web Publication24-Feb-2020

Correspondence Address:
Santosh K Chaturvedi
Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_120_19

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How to cite this article:
Chaturvedi SK. Problems and needs of patients in palliative care. Cancer Res Stat Treat 2020;3:115

How to cite this URL:
Chaturvedi SK. Problems and needs of patients in palliative care. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Apr 4];3:115. Available from: http://www.crstonline.com/text.asp?2020/3/1/115/279079



It is refreshing to read a study on quality of life (QOL), problems, and needs of palliative care among patients in India[1] and the accompanying editorial on the topic.[2] It is a rather simple survey on problems and needs, but this itself is quite informative and quite useful for planning services. The findings are not surprising but can be a clinically useful message for those involved in providing palliative care for patients with advanced cancer.

As expected, needs are more about physical distress, financial difficulties, and expectations from the doctors and specialists. Communication and information-related needs are the areas of focus in palliative care. The most important take-away message is that the needs are not only pain related but also related to social, psychological, spiritual, and communication. The information tapped by the health-related QOL (HRQOL) scale supplements the information collected by the problems and needs assessment instrument. The information on HRQOL is missing as to how many patients had poor, satisfactory, or good QOL.

The study would have been more informative and useful for Indian settings if a cultural adaptation of the problems and needs questionnaire had been performed before using the instrument. This scale has been developed in the West, and many items are irrelevant in the Indian setting. For example, the well-established general practitioner (GP) and specialist system in the West are non-existent in our country. No wonder, there are very high proportion of subjects reporting that they expect their GP and specialist to pay more attention to a number of aspects. Thus, these indicate the needs of the patients and not their satisfaction with their GPs or specialists as interpreted by the authors and mentioned in their results.[1]

The present study, which used the cross-sectional descriptive survey method, could have avoided the use of structured scales that are not fully applicable in the Indian context. Even the items on spirituality are slightly alien, and the most common spiritual concept of karma is missing. Spiritual needs and well-being are after all, an important part of QOL of patients with advanced cancer.[3],[4] The authors could have also discussed the challenges and ethical dilemmas one faces in providing palliative care in Indian settings based on these needs and problems.[5] In clinical practice, perhaps, needs and problem assessments should be done for each individual case, to plan multidisciplinary palliative care.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Asthana S, Bhatia S, Dhoundiyal R, Labani SP, Garg R, Bhatnagar S. Quality of life and needs of the Indian advanced cancer patients receiving palliative care. Cancer Res Stat Treat 2019;2:138-44.  Back to cited text no. 1
  [Full text]  
2.
Salins N. Health-related quality of life: Is it a missing feature in the Indian cancer setting? Cancer Res Stat Treat 2019;2:213-4.  Back to cited text no. 2
  [Full text]  
3.
Kandasamy A, Chaturvedi SK, Desai G. Spirituality, distress, depression, anxiety, and quality of life in patients with advanced cancer. Indian J Cancer 2011;48:55-9.  Back to cited text no. 3
[PUBMED]  [Full text]  
4.
Gielen J, Bhatnagar S, Chaturvedi SK. Prevalence and nature of spiritual distress among palliative care patients in India. J Relig Health 2017;56:530-44.  Back to cited text no. 4
    
5.
Chaturvedi SK. Ethical dilemmas in palliative care in traditional developing societies, with special reference to the Indian setting. J Med Ethics 2008;34:611-5.  Back to cited text no. 5
    




 

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