Process Challenges in Palliative Care for Cancer Patients: A Qualitative Study.

Background: Quality assessment and service delivery processes for cancer patients are the major components of palliative care. This study intends to explore stakeholder's perceptions of palliative care process challenges for cancer patients in Iran. Method: In this qualitative study, we conducted 22 semi-structured interviews from February 2016 to August 2017 in hospitals located in Tehran, Iran. Participants were selected through purposive sampling and included cancer patients, their family caregivers, healthcare providers, and policy-makers. The interviews were analyzed by qualitative directed content analysis based on the Donabedian model. In order to assess the accuracy and validity of the study, we used Lincoln and Guba's four criteria. Results: After analysis of the interviews, we categorized the codes into a main category, "process", and three identified subcategories - "weakness of stakeholders' engagement policies", "standardized care", and "applying educational and research approaches". Conclusion: Palliative care in Iran is a recent discipline. The results have shown that the process of providing services requires the attention of the health system to the standard models for providing palliative care services. In addition, it is necessary to train human resources in generalist and specialist palliative care groups, design palliative medicine curricula, inform general public about cancer, and empower patients and caregivers. [ABSTRACT FROM AUTHOR]