Stigmas and barriers to palliative care and implications for cancer patients: a systematic review
International Journal of Development Research
Stigmas and barriers to palliative care and implications for cancer patients: a systematic review
Received 10th June, 2022; Received in revised form 28th June, 2022; Accepted 07th July, 2022; Published online 17th August, 2022
Copyright © 2022, Pedro Henrique Correia Vilela et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction: Although the literature recognizes the benefits of Palliative Care (PC) integrated with standard cancer treatment, access to PC is limited by barriers and stigmas and ends up directly influencing the care and support of cancer patients and their family caregivers. Objective: To analyze the implications of stigmas and barriers related to palliative care in the care of cancer patients. Methods: Systematic review study using Medline, SciELO, and LILACS databases to search for studies published from 2017 to 2022. The search was conducted considering the terms “stigmas”, “barriers”, “palliative care” and “cancer”. The quality of articles was assessed using the Study Quality Assessment Tool from the Department of Health and Human Services. Results: A total of 63 studies were identified; 8 studies were eligible and included. North America and Europe were the countries with the highest number of studies included (n=3, n=2, respectively). The stigmas and barriers related to PC identified were administrative, economic, institutional (n=3), cultural (n=2), knowledge (n=6), communication (n=3), geographic (n=1) and social ( n=1). Inaccessibility to PC or late referral as a result of PC-related stigma and/or barriers was identified in all studies. Patients with the maintenance of the expectation of healing, receiving futile care at the end of life (n=1), impact on the desires for end-of-life care, autonomy and dignity (n=1), unmanaged psychological and spiritual suffering (n=1), purchase of drugs for analgesia with own resources (n=1); non-shared decision-making (n=1) and worsening of the mental health of professionals in pediatric oncology (n=1). Conclusion: The barriers and stigmas related to PC can influence the care received by patients, especially in end-of-life care, due to lack of access to PC or late access. Heterogeneity regarding study design and results, and low methodological quality are challenges when reaching conclusions.
