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Developing a palliative care service model for Muslim Middle Eastern countries

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Abstract

Purpose

Palliative Care (PC) was first introduced to Muslim Middle Eastern (MME) countries in 1992, but growth of PC has been slow and access to PC is still limited in the region. While most PC models have been developed in Western countries, MME societies have different cultural and religious values that are not incorporated in Western models. We conducted a qualitative study to look at these differences, in order to inform a culturally acceptable model of PC that meets the needs of MME patients and their families.

Methods

We conducted semi-structured interviews of PC physicians and nurses with experience in both Western and MME countries. Participants were identified by snowball sampling. Interviews were transcribed and analyzed using a modified grounded-theory approach.

Results

We achieved conceptual saturation after 13 interviews. Participants identified four differences between PC practice in Western and MME countries including: cultural differences, legal and policy differences, stances on PC philosophy, and the availability of resources and support for PC. Participants identified five barriers to advancing PC in the MME: shortage of resources, unclear laws and policies, healthcare system barriers, unfamiliarity with the role and benefits of PC, and cultural barriers. Respondents suggested many facilitators at the institutional, regional, and societal levels.

Conclusions

We identified a number of important differences in PC practice, as well as common barriers and facilitators for developing PC services in MME countries. This information can help clinicians who are developing PC services in a MME country.

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Acknowledgments

We would like to thank the study's participants for thier thoughtful quotes and valuable contributions.

Conflicts of interest

The authors have no conflicts of interest to declare. The authors have full control of all primary data and we agree to allow the journal to review the data if requested.

Contribution

Both authors contribute to study design. AA conducted literature searches. Both authors conducted interviews, analyzed the data, and participated in data interpretation. AA drafted the original manuscript. JD revised the manuscript critically. Both authors approved the final version of the manuscript.

Funding

This study was supported by the Toronto General Hospital Foundation.

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Correspondence to James Downar.

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al-Awamer, A., Downar, J. Developing a palliative care service model for Muslim Middle Eastern countries. Support Care Cancer 22, 3253–3262 (2014). https://doi.org/10.1007/s00520-014-2347-4

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