Community-Based Palliative Care for Chronic Cancer Patients in the Philippines

Calimag, Maria Minerva P.

doi:10.1007/978-3-030-54526-0_51

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…Our findings show that the most commonly reported perceived and preferred decision-making role in all countries was no patient involvement. This is likely due to the fact that countries involved in this study can be identified as collectivistic societies, where the family is a main stakeholder in decisions 5 , 35 – 38 and a more paternalistic view of physicians is prevalent. 37 These findings suggest that despite the evidence on increasing support for and promotion of SDM in high-income Asian countries, 39 – 41 a passive role in decision-making may still be commonly experienced and preferred among advanced cancer patients in low and middle income countries in Asia.…”

Section: Discussionmentioning

confidence: 99%

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Özdemir

Malhotra

Teo

et al. 2021

MDM Policy & Practice

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Purpose. We investigated 1) perceived roles in decision-making among advanced cancer patients in 5 Asian countries 2) associations of patient characteristics with these roles, and 3) the association of perceived roles with quality of life and perceived quality of care. Methods. We surveyed 1585 patients with stage IV solid cancer. Multinomial logistic regressions were used to analyze associations of patient characteristics with decision-making roles. Multivariate regressions were used to analyze associations of decision-making roles with quality of life and care. Results. The most common perceived-role was no patient involvement. Most patients (73%) reported roles consistent with their preferences. Being male, nonminority, higher educated, aware of advanced cancer diagnosis, and knowledge of cancer diagnosis for ≥1 year were associated with higher levels of patient involvement in decision-making. Compared to no patient involvement, joint decision-making (together with physicians/family) was associated with higher social (β = 2.49, P < 0.01) and spiritual (β = 2.64, P < 0.01) well-being, and better quality of physician communication (β = 9.73, P < 0.01) and care coordination (β = 13.96, P < 0.01) while making decisions alone was associated with lower emotional (β = −1.43, P < 0.01), social (β = −2.39, P < 0.01), and spiritual (β = −2.98, P < 0.01) well-being. Conclusions. Findings suggest that a substantial number of advanced cancer patients were not (and preferred not to be) involved in decision-making. Despite this finding, joint decision-making together with physicians/family was associated with better quality of life and care. Implications. Physicians should explain the benefits of shared decision making to patients and encourage participation in decision-making, while ensuring that patients feel supported and do not find decision-making overwhelming.

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Section: Discussionmentioning

confidence: 99%

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Özdemir

Malhotra

Teo

et al. 2021

MDM Policy & Practice

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“…The tightly knit nature of the Filipino family plays an instrumental role in patient care, with family members often acting as decision-makers during times of illness. 29 This is especially true for elders, whose opinions are strongly respected within the family structure. 29 Furthermore, strong expectations of care by the family, with even extended family representing a source of support and assistance, may influence the care of terminally ill patients.…”

Section: Filipino Cultural Barriersmentioning

confidence: 99%

“…29 This is especially true for elders, whose opinions are strongly respected within the family structure. 29 Furthermore, strong expectations of care by the family, with even extended family representing a source of support and assistance, may influence the care of terminally ill patients. 29 Conversely, patients consider family opinions when deciding about their care, with many preferring home-based care surrounded by family and friends at end of life, over structured palliative care in a hospital setting.…”

Section: Filipino Cultural Barriersmentioning

confidence: 99%

Palliative and Supportive Care in the Philippines: Systems, Barriers, and Steps Forward

Luna

Cubarrubias

et al. 2023

J Palliat Care

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Although integral to alleviating serious health-related suffering, global palliative care remains systemically and culturally inaccessible to many patients living in low- and middle-income countries. In the Philippines, a lower-middle income country in Southeast Asia of over 110 million people, up to 75% of patients with cancer suffer from inadequate pain relief. We reviewed factors that preclude access to basic palliative care services in the Philippines. PubMed and Google Scholar were searched thoroughly; search terms included but were not limited to “palliative care,” “supportive care,” “end-of-life care,” and “Philippines.” We found that a limited palliative care workforce, high out-of-pocket healthcare costs, and low opioid availability all hinder access to palliative care in the archipelago. Religious fatalism, strong family-orientedness, and physician reluctance to refer to palliative care providers represent contributory sociocultural factors. Efforts to improve palliative care accessibility in the country must address health systems barriers while encouraging clinicians to discuss end-of-life options in a timely manner that integrates patients’ unique individual, familial, and spiritual values. Research is needed to elucidate how Filipinos—and other global populations—view end-of-life, and how palliative care strategies can be individualised accordingly.

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Community-Based Palliative Care for Chronic Cancer Patients in the Philippines

Cited by 2 publications

References 21 publications

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Patient-Reported Roles in Decision-Making Among Asian Patients With Advanced Cancer: A Multicountry Study

Palliative and Supportive Care in the Philippines: Systems, Barriers, and Steps Forward

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