Barriers and Facilitators of Early Palliative Care in the Trajectory of People Living with Chronic Condition: A Mini Review Using Socio-ecological Framework to Inform Public Health Strategy

Abstract

Hartiah Haroen,1,* Sidik Maulana,2,* Alia Rahmi Harlasgunawan,2,3 Sri Rahmawati,2 Alvi Riansyah,2 Faizal Musthofa,4 Jerico Franciscus Pardosi5 1Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 2Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia; 3Nursing Department, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia; 4Nursing Department, Universitas Padjadjaran Hospital, Sumedang, Indonesia; 5School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia*These authors contributed equally to this workCorrespondence: Hartiah Haroen, Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Ir. Soekarno KM, 21, Jatinangor, Sumedang, 45363, West Java, Indonesia, Tel [phone], Email [email protected]: The increasing incidence of chronic conditions on a global scale requires a comprehensive approach to palliative care, which is recognized as an essential element of the continuum of care for people with life-threatening conditions. It has been argued that the integration of early palliative care for people with chronic conditions is beneficial. Nevertheless, barriers to integrating early palliative care have been extensively not reviewed. This review aimed to explore the barriers and facilitators of integrating early palliative care for people living with chronic conditions, employing a socio-ecological framework to provide a critical understanding of the influencing factors at multiple levels. The method was a mini review. This review emphasizes the complex and diverse factors that either hinder or facilitate progress in four areas: individual (such as gaps in knowledge and emotional reactions), interpersonal (such as support from family caregiver), healthcare professionals and policy (such as barriers in education, guidelines, and collaboration among professionals), and community (such as societal knowledge and attitudes). Each level presents unique challenges and opportunities for enhancing early palliative care integration, from addressing misconceptions and fears at the individual level, to fostering supportive policies and community awareness. In conclusion, the effective management of early palliative care requires a comprehensive strategy that spans various dimensions, including educational initiatives, policy adjustments, and active involvements of the community. Healthcare systems are supposed to enhance the integration of early palliative care into the trajectory of chronic conditions and enhance the quality of life of affected persons and their families by recognizing and addressing the socio-ecological elements involved.Keywords: barrier, early palliative care, facilitator, people living with chronic condition

Keywords

• barrier
• early palliative care
• facilitator
• people living with chronic condition