Patient-centeredness and determinant factors of palliative care service for adult cancer patients in public hospitals of addis Ababa, Ethiopia, 2024: cross-sectional mixed method study.

Abstract

Introduction: Providing patient centered palliative care is essential to enhance the wellbeing of patients with life-limiting illnesses and their families. As the demand for palliative care services increases and the cancer burden grows in Ethiopia, it is crucial to know how much these services are patient centered and what factors may determine it. Therefore, this study assess the level and determinant factors of patient-centeredness for adult cancer patients' palliative care services in public hospitals found in Addis Ababa.

Method and materials: A cross-sectional mixed method was employed from May 16 to August 19, 2024. A total of 407 adult cancer patients, 7 key informant interviews and five in-depth interviews were included. The quantitative data was collected using Kobo collect tool version 2.023.21 and exported to STATA version 14 for analysis. Binary and multi-variable logistic regression with 95% Confidence Interval (CI) and Adjusted Odds Ratio (AOR) were fitted to identify factors associated with the patient-centeredness of care. Qualitative data was recorded, transcribed and thematically analyzed by using Open Code software version 4.0.1.

Results: Patient-centeredness care for adult cancer patients was 77.9%. age group 30-39 (AOR: 3.52, 95% CI: 1.21, 10.21), being divorced (AOR: 0.14 95%, CI: 0.06, 0.37), monthly income > 12,000 Birr (AOR: 0.36, 95 CI: 0.156, 0.836), health literacy (AOR: 0.08, 95% CI: 0.02, 0.25), intimacy with the provider (AOR: 0.14 95% CI: 0.02, 0.75), service easiness (AOR: 0.34, 95% CI: 0.17, 0.67), and appointment waiting time (AOR: 0.4 95% CI: 0.19, 0.83) were found to be significant factors for patient-centeredness of palliative care service.

Conclusion and recommendations: The magnitude of patient-centered care for adult cancer patients in palliative care was 77.9%. Most patients felt respected and involved in decision-making, and their physical and emotional comfort was maintained. However, only one-third of them reported ease of access to services. Age, marital status, income, participation in decision-making, intimacy with providers, ease of access, and appointment length was the significant factors. Recommendations include improving service coordination, reducing waiting time, fostering emotional connections between patients and providers, and offering tailored support to single or widowed patients to enhance patient-centered care.