# Exploring the perceptions of oncology healthcare professionals on introducing home-based palliative care for patients with advanced cancer in Gaza - a qualitative study

## TL;DR

This study explores how healthcare professionals in Gaza view the introduction of home-based palliative care for advanced cancer patients, highlighting challenges like conflict and funding.

## Contribution

The study provides new insights into the feasibility and challenges of implementing home-based palliative care in a conflict-affected, low-resource setting like Gaza.

## Key findings

- Healthcare professionals recognize palliative care's role beyond physical care.
- Shortages of experts, funding, and political conflict are major barriers.
- Suggestions for overcoming challenges include training and community involvement.

## Abstract

Palliative care aims to improve the quality of life for those with life-limiting diseases. It is still an emerging specialty in Palestine with limited governmental funding and underdeveloped national palliative care policies. Yet, the high burden of cancer and ongoing conflict in Gaza have increased the need for palliative care. Home-based palliative care has emerged as a promising approach to address the unmet needs of patients with advanced cancer, particularly in low-resource settings. This research aims to explore the perceptions of the oncology healthcare team on introducing home-based palliative care for patients with advanced cancer in a tertiary center in Gaza.

This is a qualitative study that was carried out at the Turkish Palestinian Friendship Hospital in Gaza. Semi structured face-to-face interviews were conducted with 15 healthcare professionals working in the oncology department. Data collection took place between March and May 2023, and the data were analyzed via a thematic analysis approach to identify themes and subthemes.

The thematic analysis generated four main themes and fourteen subthemes were generated from the thematic analysis. The main themes include general perceptions about palliative care, perceptions of home-based palliative care, challenges in the provision of home-based palliative care, and suggestions to overcome challenges. The purpose of palliative care was recognized to extend beyond standard physical care. The introduction of palliative care services in Gaza remains in its infancy. Shortages of palliative care experts, budget constraints, endemic conflicts and cultural sensitivity were reported to be significant challenges for its development. However, several suggestions to address these obstacles have also been presented.

Although developing home-based palliative care could be beneficial to cancer patients, their families and healthcare system, the political conflict represents one of the main barriers to its development. To comprehensively understand and develop an effective model for home-based palliative care, future research should include broader perspectives including families and communities.