Organizing palliative care in the rural areas of Iran: are family physician-based approaches suitable?

• Published in: Journal of pain research Vol. 12; pp. 17 - 27
• Main Authors: Jabbari, Hossein, Azami-Aghdash, Saber, Piri, Reza, Naghavi-Behzad, Mohammad, Sullman, Mark Jm, Safiri, Saeid
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2019; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Cancer; Epidemiology; Family medicine; Family physicians; Health care industry; Health care policy; Health facilities; Health insurance; Nurses; Original Research; Palliative care; Palliative End-of-Life care; Palliative treatment; Patients; Physicians (General practice); Primary care; Public health; Qualitative research; Rural area; Rural areas; Sparsely populated areas; Systematic review; Iran; rural areas; palliative end-of-life care; family physician team
• ISSN: 1178-7090; 1178-7090
• DOI: 10.2147/JPR.S178103

The provision of palliative end-of-life care (P/EOLc) for patients, wherever they live, is an increasingly important service, particularly given the increasing rates of cancer and other life-threatening diseases in Iran. However, unfortunately, those living in the rural areas of Iran are greatly disadvantaged with respect to this type of care. Therefore, the present study explored the feasibility of organizing P/EOLc in the rural areas of Iran. In this qualitative study, two focus group (FG) discussions were held in Tabriz (Iran) with rural family physicians (FPs, n=23) and key P/EOLc stakeholders (n=13). The FG sessions were recorded, transcribed, and the transcriptions checked by participants before the data were subjected to content analysis. While most FPs indicated that they did not have sufficient involvement in providing P/EOLc, they emphasized the necessity of providing P/EOLc through four main themes and 25 subthemes. The four main themes were labeled as "structures and procedures," "health care provider teams," "obstacles," and "strategies or solutions." Furthermore, according to the main themes and subthemes identified here, the key stakeholders believed that the Iranian health system and the FPs' team have the potential to provide P/EOLc services in rural areas. The most feasible strategy for providing P/EOLc in Iranian rural areas would be to use the current health care framework and base the process around the FP.