Palliative Care in Turkey: Insights from experts through key informant interviews

Background: The rising demand for palliative-care (PC) in Turkey, driven by cancer, has prompted increased attention since the national PC policy in 2010. Despite this, the healthcare system predominantly focuses on curative care, lacking PC integration. This is due to combination of administrative obstacles, fragmented coordination, education and training scarcity. Thus urgent strategies are required to address the growing PC gap. This qualitative study explores the perspectives of PC professionals and policymakers, providing valuable insights for national policy and program development. Material and method: This study employed an exploratory approach using key informant interviews. Interviews were conducted using semi-structured questionnaire. It sought to collect relevant contextual information in order to achieve its aim. Thematic content analysis was employed to examine and interpret the data. Result: Twenty-one participants, comprising nurses, specialists, and oncologists, were interviewed. The findings are encompassed by eight themes. 1) Integrated Care, highlights the importance of cohesive collaboration among diverse healthcare providers, social care services, and primary care systems to ensure comprehensive and effective care. 2) Meeting social care needs underscores significance of addressing a wide spectrum of patient requirements, including psychosocial support. 3) PC education emphasizes necessity of equipping healthcare professionals with the requisite skills and knowledge through comprehensive training. 4) Legalizing do-notresuscitate orders draws attention to the critical discussion surrounding end-of-life decisions. 5) Empowering communities recognizes bridging knowledge gaps among patients and caregivers. 6) Decision-Making underscores the importance of informed and collaborative decision-making processes. 7) Cultural considerations urge the adoption of culturally sensitive approaches. 8) Ongoing challenges shed light on persistent issues such as provider attitudes, and administrative hurdles. Conclusion: This study highlights essential factors for establishing an integrated PC program for cancer patients in Turkey. The existing healthcare system in Turkey offers opportunities for advanced PC. Successful implementation demands strategic actions to facilitate meaningful transformation.