Preference for palliative care among low-income advanced cancer patients in Mainland China: a qualitative study

Abstract

Abstract Background Previous studies have highlighted the significant impact of income on access to palliative care. However, few studies have explored the treatment preferences of low-income patients with advanced cancer. These individuals require additional support in terms of palliative care, including financial psychological, spiritual, and social assistance. Therefore, it is essential to conduct more qualitative research with a particular emphasis on the preferences of this population. Aim To explore the preference and influencing factors of palliative care among low-income advanced cancer patients in mainland China. Design A qualitative study design with a hermeneutic phenomenological approach was used. Methods Semi-structured interviews were conducted with a purposive sample of 23 low-income advanced cancer patients in mainland China. The collected data was analyzed thematically using Giorgi's methodology. The COREQ checklist was used. Results Four themes emerged from the analysis: (1) Economic status is crucial for palliative preference selection, which affects the patient’s choice of treatment, drugs and whether to continue with palliative care; (2) Family members and medical personnels’ support strengthens determination to receive palliative treatment; (3) The Chinese traditional culture of returning to one’s roots influences the choice of place of death, surgery and intubation; (4) Patients with advanced cancer tend to prefer the comfort care, refuse to be awakened and agree to sedation to reduce consciousness and thus relieve suffering. Conclusions The preferences of low-income patients with advanced cancer were influenced by economic status, social support, cultural beliefs, and the desire to alleviate suffering. Therefore, medical professionals should be patient with patients, respect them, and provide psychological support. And strengthen patients’ economic support by improving medical insurance policies and providing social assistance. At the same time, medical policymakers and clinical staff should respect patients’ cultural values and treatment preferences when developing treatment plans.

Keywords

• Palliative care
• Advanced cancer
• Low income
• Phenomenology
• Qualitative research
• Preference