End of Life in Patients with Incurable Cancer. Patient Perceptions about the Health System

Abstract

Objective: To identify and analyze experiences and opinions that cancer patients without a curative option have regarding their palliative care and end-of-life wishes. Methods: Qualitative study with a critical-constructivist perspective. Twenty-two in-depth interviews were conducted with patients between 28 and 78 years old, who suffered from some of the most frequent cancers (breast, cervix, colon, stomach, among others, with a life expectancy between six and twelve months) treated at the Hospital Universitario San José de Popayán, Hospital Universitario San Ignacio, and the National Institute of Cancerology in Bogotá. Results: Two categories of patient experiences and desires were identified: The first category is related to the care and information patients wish to receive from the health personnel. The second category is related to the health system, which includes administrative problems with the EPS; the importance of providing continuity in medical care; the opportunity in the delivery of medications and the assignment of appointments and the hospital infrastructure directed towards the Institution where patients wish to be. Conclusions: The results of the study contribute to the understanding of experiences that patients with incurable cancer have had with the health system. It is necessary to educate health workers about the need to investigate and discuss of the patient's wishes in order to offer them better options that optimize their quality of life. It is necessary to improve the infrastructure of palliative care units and emergency rooms, as well as the appointment scheduling and the timely delivery of medications.