Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh
Abstract Objectives Palliative care (PC) is an interdisciplinary approach aimed at improving the physical, psychological, and spiritual well-being of patients and families affected by life-threatening diseases. This study aimed to investigate the need for PC among critically ill patients and their q...
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BMC
2025-01-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-024-01643-9 |
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| author | Ahmed Hossain Maruf Hasan Taifur Rahman Alounoud Almarzooqi Syed Azizur Rahman Heba Hijazi Mohamad Alameddine |
| author_facet | Ahmed Hossain Maruf Hasan Taifur Rahman Alounoud Almarzooqi Syed Azizur Rahman Heba Hijazi Mohamad Alameddine |
| author_sort | Ahmed Hossain |
| collection | DOAJ |
| description | Abstract Objectives Palliative care (PC) is an interdisciplinary approach aimed at improving the physical, psychological, and spiritual well-being of patients and families affected by life-threatening diseases. This study aimed to investigate the need for PC among critically ill patients and their quality of life (QOL) in low-income groups in Bangladesh. Methods This cross-sectional study was conducted at four healthcare facilities from March to April 2023, involving 553 registered patients with advanced chronic conditions. After applying inclusion and exclusion criteria, 183 patients in the advanced stage of illness were included. We collected data on sociodemographic, comorbidities, disabilities, and the 10-item African Palliative Outcome Scale (APOS). The Supportive and Palliative Care Indicators Tool (SPICT) was used to identify individuals requiring PC. The study investigated patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 3–4, indicating significant functional impairment, and explored QOL across four domains: physical health, psychological health, social relationships, and environmental factors. Results The mean age of the 183 patients was 53.8 (± 14.53) years, with 69.5% being female. We found that 10.3% of patients with chronic illness required PC, particularly cancer patients (87%) and those with chronic kidney disease (CKD) (53.3%). The APOS scores indicated that family anxiety (48.6%) was the most burdensome issue, followed by severe pain (15.5%), severe worry about illness (22.4%), and feelings of life being unworthy (9.4%). Patients with severe functional limitations (ECOG 3–4) were significantly more likely to need PC (58%) compared to those with moderate or no limitations (ECOG 0–2) (24%). Among those requiring PC, 70.1% rated their QOL as poor or very-poor, while only 23.8% of patients not needing PC reported similar ratings. Female patients had poorer QOL than males across all domains, and those facing financial hardships also experienced significantly lower QOL. Conclusion In Bangladesh’s low-income communities, a significant proportion of patients with chronic illnesses require palliative care (PC) due to advanced conditions. The findings emphasize the importance of integrating PC early in the treatment process for cancer and CKD patients, as it can greatly improve their QOL and provide essential support for both patients and families. The results advocate for a holistic approach to PC that addresses physical, psychological, social, and environmental factors affecting patients’ QOL. |
| format | Article |
| id | doaj-art-856633077e7c445ba17d50bb74799d30 |
| institution | Kabale University |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-856633077e7c445ba17d50bb74799d302025-01-19T12:43:11ZengBMCBMC Palliative Care1472-684X2025-01-0124111110.1186/s12904-024-01643-9Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of BangladeshAhmed Hossain0Maruf Hasan1Taifur Rahman2Alounoud Almarzooqi3Syed Azizur Rahman4Heba Hijazi5Mohamad Alameddine6College of Health Sciences, University of SharjahFaculty of Medical Studies, Bangladesh , University of ProfessionalsDepartment of Public Health, Missouri State UniversityCollege of Health Sciences, University of SharjahCollege of Health Sciences, University of SharjahCollege of Health Sciences, University of SharjahCollege of Health Sciences, University of SharjahAbstract Objectives Palliative care (PC) is an interdisciplinary approach aimed at improving the physical, psychological, and spiritual well-being of patients and families affected by life-threatening diseases. This study aimed to investigate the need for PC among critically ill patients and their quality of life (QOL) in low-income groups in Bangladesh. Methods This cross-sectional study was conducted at four healthcare facilities from March to April 2023, involving 553 registered patients with advanced chronic conditions. After applying inclusion and exclusion criteria, 183 patients in the advanced stage of illness were included. We collected data on sociodemographic, comorbidities, disabilities, and the 10-item African Palliative Outcome Scale (APOS). The Supportive and Palliative Care Indicators Tool (SPICT) was used to identify individuals requiring PC. The study investigated patients with an Eastern Cooperative Oncology Group (ECOG) performance status of 3–4, indicating significant functional impairment, and explored QOL across four domains: physical health, psychological health, social relationships, and environmental factors. Results The mean age of the 183 patients was 53.8 (± 14.53) years, with 69.5% being female. We found that 10.3% of patients with chronic illness required PC, particularly cancer patients (87%) and those with chronic kidney disease (CKD) (53.3%). The APOS scores indicated that family anxiety (48.6%) was the most burdensome issue, followed by severe pain (15.5%), severe worry about illness (22.4%), and feelings of life being unworthy (9.4%). Patients with severe functional limitations (ECOG 3–4) were significantly more likely to need PC (58%) compared to those with moderate or no limitations (ECOG 0–2) (24%). Among those requiring PC, 70.1% rated their QOL as poor or very-poor, while only 23.8% of patients not needing PC reported similar ratings. Female patients had poorer QOL than males across all domains, and those facing financial hardships also experienced significantly lower QOL. Conclusion In Bangladesh’s low-income communities, a significant proportion of patients with chronic illnesses require palliative care (PC) due to advanced conditions. The findings emphasize the importance of integrating PC early in the treatment process for cancer and CKD patients, as it can greatly improve their QOL and provide essential support for both patients and families. The results advocate for a holistic approach to PC that addresses physical, psychological, social, and environmental factors affecting patients’ QOL.https://doi.org/10.1186/s12904-024-01643-9Palliative carePalliative care needsQuality of lifeFunctional statusSlumsBangladesh |
| spellingShingle | Ahmed Hossain Maruf Hasan Taifur Rahman Alounoud Almarzooqi Syed Azizur Rahman Heba Hijazi Mohamad Alameddine Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh BMC Palliative Care Palliative care Palliative care needs Quality of life Functional status Slums Bangladesh |
| title | Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh |
| title_full | Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh |
| title_fullStr | Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh |
| title_full_unstemmed | Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh |
| title_short | Palliative care needs and quality of life among adults with advanced chronic illnesses in low-income communities of Bangladesh |
| title_sort | palliative care needs and quality of life among adults with advanced chronic illnesses in low income communities of bangladesh |
| topic | Palliative care Palliative care needs Quality of life Functional status Slums Bangladesh |
| url | https://doi.org/10.1186/s12904-024-01643-9 |
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