title: How to provide care for patients suffering from terminal non-oncological diseases: barriers to a palliative care approach.
abstract: Despite the seemingly evident pertinence of palliative care for patients suffering from non-oncological long-term life-threatening diseases, everyday clinical practice is far from that assumption. This study aims to explore palliative care service provision for these patients in Spain. Patients, family caregivers and healthcare professionals were interviewed, individually or in a group, aiming at identifying barriers in the provision of care and strategies to overcome them. Ritchie and Spencer's framework was used for data analysis. The barriers identified were as follows: lack of clarity about prognosis, the hegemony of the curative approach, avoiding words and the desire to cheat death. Provision of palliative care services for these patients should be guided by the characteristic trajectory of each type of disease. Even if healthcare systems were capable of providing specialized palliative care services to this large group of patients, other barriers should not be overlooked. It would then seem appropriate to provide therapeutic and palliative care simultaneously, thus facilitating adaptation processes for both patients and relatives.
authors.affiliation: Canary Islands Health Care Services, Primary Care Management, Spain. vinitavivek@hotmail.com
authors.forename: Vinita
authors.initials: V
authors.lastname: Mahtani-Chugani
authors.forename: Inmaculada
authors.initials: I
authors.lastname: González-Castro
authors.forename: Amaia Sáenz
authors.initials: AS
authors.lastname: de Ormijana-Hernández
authors.forename: Roberto
authors.initials: R
authors.lastname: Martín-Fernández
authors.forename: Enrique Fernández
authors.initials: EF
authors.lastname: de la Vega
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006302:Health Services Research / Q000379:methods; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D013030:Spain; D013727:Terminal Care / Q000458:organization & administration*