Needs Assessment of Patients Requiring End-of-Life Care: A Community-based Cross-sectional Study

The first step in implementing comprehensive palliative care is to assess the need for it within the community. Therefore, our study aimed to determine the number of individuals requiring end-of-life care in the rural sectors in the peri-urban area and to evaluate the unmet needs of the identified patients.

Data triangulation was conducted using information from health workers in the respective villages, cancer registry data from the District Headquarters Hospital, and snowball sampling. The identified patients were interviewed using a semi-structured questionnaire that included socio-demographic information, disease details and assessments across four domains of palliative care.

A total of 225 patients were identified. Among these patients, 55.9% were over the age of 60 years, while 8.0% were children and adolescents. The most common diseases identified included cerebrovascular disease, heart disease, frailty, cancer and chronic kidney disease among adults and cerebral palsy among children. The prevalent physical issues reported were immobility, pain, fatigue, breathlessness and constipation. Approximately two-thirds of the patients expressed concerns regarding their future and financial issues. Three out of four patients reported difficulties in performing daily activities. Most of the patients attributed their source of strength to their relationships with others, followed by their faith in God. Socioeconomic factors such as education, occupation, family type and income were found to influence various domains of palliative care, except the spiritual domain.

In the studied population, 4.3 individuals/1,000 required end-of-life care. In addition, all four domains of care exhibited unmet needs. These needs can be addressed through policy implementation and the integration of palliative care into primary care services.