{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:55:10Z","timestamp":1755226510159,"version":"3.43.0"},"reference-count":22,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"\nObjectives:<\/jats:title>\nPalliative care services are envisioned to enhance the quality of life (QoL) of patients suffering from life-limiting illness. Across the world, a need for extending home-based palliative services to secondary care facilities of the public health system has been felt recently to deal with the rising demand for speciality nursing care and physiotherapy services for palliative patients. Kerala, a pioneer state in universalising palliative care attached to primary care facilities, is implementing the pain and palliative care policy, Government of Kerala, 2019, to initiate palliative services attached to secondary care facilities primarily by establishing a home-based palliative unit (HBPU). To understand the micro-level impact, an attempt is made to assess the QoL of patients registered in a best-performing HBPU attached to a secondary care facility in Kerala and to identify how far the intervention of the palliative unit has impacted the QoL of beneficiaries. To analyse the impact of secondary HBPU on the QoL of its beneficiaries.<\/jats:p>\n<\/jats:sec>\n\nMaterials and Methods:<\/jats:title>\nThe study uses data collected from thirty-eight beneficiaries selected randomly and attached to the palliative unit. Information on various domains of QoL, including the physical, psychological, social, existential, feeling of burden, physical environment, cognition and health awareness, is collected using the McGill QoL Questionnaire-expanded (MQOL-E). In addition, patients were asked how far the QoL has been affected by the intervention of HBPU, rated using a scale of one to ten, with one representing no considerable impact and ten depicting dominant impact.<\/jats:p>\n<\/jats:sec>\n\nResults:<\/jats:title>\nThe QoL of beneficiaries attached to the HBPU unit is above the mean score for most domains except the cognitive domain. Patients perceive a better QoL regarding the social domain, physical environment and health awareness of MQOL-E. Reasonably, these are the domains where patients perceive the dominant impact of HBPU intervention, depicting the effectiveness of secondary palliative care attached to the public health system. The intervention of the HBPU unit could significantly impact health awareness. Along with providing medical care, the HBPU succeeded in providing non-medical services such as psychosocial, financial and rehabilitative support to patients, improving the QoL connected to these domains. This is a result of the coordinated working of the HBPU with the primary care unit, respective Local Self Government Institutions and other government departments and a trained, multifaceted team functioning empathetically to patient needs.<\/jats:p>\n<\/jats:sec>\n\nConclusion:<\/jats:title>\nSecondary HBPU units attached to the public health system enhance patients\u2019 QoL by enhancing health awareness and psychosocial well-being and reducing feelings of burden. This depicts the significance of HBPUs attached to the secondary level, planned and coordinated at the community level to provide speciality palliative care.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/ijpc_9_2025","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T05:20:36Z","timestamp":1752470436000},"page":"1-6","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary Home-based Palliative Care: Impact on Quality of Life of Beneficiaries"],"prefix":"10.25259","volume":"0","author":[{"given":"Manju Saraswathy","family":"Nair","sequence":"first","affiliation":[{"name":"Department of Economics, University of Kerala, Trivandrum, Kerala, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anupama","family":"Augustine","sequence":"additional","affiliation":[{"name":"Centre for Agroecology and Public Health, University of Kerala, Trivandrum, Kerala, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Gopika","family":"Nair","sequence":"additional","affiliation":[{"name":"Centre for Agroecology and Public Health, University of Kerala, Trivandrum, Kerala, India,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"10.25259\/IJPC_9_2025\/ref-1","doi-asserted-by":"publisher","first-page":"2750","DOI":"10.1200\/JCO.2011.35.9729","article-title":"Palliative Care and the Quality of Life","volume":"29","author":"Meier","year":"2011","journal-title":"J Clin Oncol"},{"key":"10.25259\/IJPC_9_2025\/ref-2","doi-asserted-by":"publisher","first-page":"4457","DOI":"10.1200\/JCO.2009.26.3863","article-title":"Place of Death: Correlations with Quality of Life of Patients with Cancer and Predictors of Bereaved Caregivers' Mental Health","volume":"28","author":"Wright","year":"2010","journal-title":"J Clin Oncol"},{"key":"10.25259\/IJPC_9_2025\/ref-3","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1001\/jama.2009.1198","article-title":"Effects of a Palliative Care Intervention on Clinical Outcomes in Patients with Advanced Cancer: The Project ENABLE II Randomized Controlled Trial","volume":"302","author":"Bakitas","year":"2009","journal-title":"JAMA"},{"key":"10.25259\/IJPC_9_2025\/ref-4","doi-asserted-by":"publisher","DOI":"10.2174\/0117450179183857240226094258","article-title":"Quality of Life in Palliative Care: A Systematic Meta-Review of Reviews and Meta-Analyses","volume":"20","author":"Demuro","year":"2024","journal-title":"Clin Pract Epidemiol Ment Health"},{"key":"10.25259\/IJPC_9_2025\/ref-5","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1016\/j.jpainsymman.2011.04.025","article-title":"Pain Intensity, Quality of Life, Quality of Palliative Care, and Satisfaction in Outpatients with Metastatic or Recurrent Cancer: A Japanese, Nationwide, Region-Based, Multicenter Survey","volume":"43","author":"Yamagishi","year":"2012","journal-title":"J Pain Symptom Manage"},{"key":"10.25259\/IJPC_9_2025\/ref-6","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.jpainsymman.2012.07.018","article-title":"Community-Based Palliative Care: The Natural Evolution for Palliative Care Delivery in the U.S","volume":"46","author":"Kamal","year":"2013","journal-title":"J Pain Symptom Manage"},{"year":"2018","author":"World Health Organisation","key":"10.25259\/IJPC_9_2025\/ref-7"},{"year":"2020","author":"World Health Organisation","key":"10.25259\/IJPC_9_2025\/ref-8"},{"volume":"2020","year":"2020","author":"World Health Organisation","key":"10.25259\/IJPC_9_2025\/ref-9"},{"key":"10.25259\/IJPC_9_2025\/ref-10","doi-asserted-by":"publisher","first-page":"375","DOI":"10.25259\/IJPC_140_2023","article-title":"Palliative Care Need in India: A Systematic Review and Meta-analysis","volume":"29","author":"Chandra","year":"2023","journal-title":"Indian J Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-11","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1179\/1743291X12Y.0000000022","article-title":"Progress in Palliative Care in India","volume":"20","author":"Palat","year":"2012","journal-title":"Prog Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-12","doi-asserted-by":"publisher","first-page":"18","DOI":"10.4103\/IJPC.IJPC_45_20","article-title":"Is the Kerala Model of Community-Based Palliative Care Operations Sustainable? Evidence from the Field","volume":"27","author":"Azeez","year":"2021","journal-title":"Indian J Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-13","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1159\/000076902","article-title":"Palliative Care in Kerala, India: A Model for Resource-Poor Settings","volume":"27","author":"Bollini","year":"2004","journal-title":"Onkologie"},{"key":"10.25259\/IJPC_9_2025\/ref-14","doi-asserted-by":"publisher","first-page":"56","DOI":"10.25259\/IJPC_223_2023","article-title":"Beneficiary's Satisfaction with Primary Palliative Care Services in Kerala-a Cross-Sectional Survey","volume":"30","author":"Krishnan","year":"2024","journal-title":"Indian J Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-15","doi-asserted-by":"publisher","first-page":"7","DOI":"10.25259\/IJPC_4_21","article-title":"Understanding Long-Term Outcomes of Public Health Strategy in Palliative Care at Micro Level: Impact of Home-Based Palliative Care Services Under Local Self-Government Institutions in Kerala, India","volume":"28","author":"Nair","year":"2022","journal-title":"Indian J Palliat Care"},{"year":"2019","author":"Government of Kerala","key":"10.25259\/IJPC_9_2025\/ref-16"},{"key":"10.25259\/IJPC_9_2025\/ref-17","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1177\/0269216313517283","article-title":"Effectiveness of Palliative Home-Care Services in Reducing Hospital Admissions and Determinants of Hospitalization for Terminally Ill Patients Followed Up by a Palliative Home-Care Team: A Retrospective Cohort Study","volume":"28","author":"Riolfi","year":"2014","journal-title":"Palliat Med"},{"key":"10.25259\/IJPC_9_2025\/ref-18","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12904-019-0473-y","article-title":"More Comprehensively Measuring Quality of Life in Life-Threatening Illness: The McGill Quality of Life Questionnaire-Expanded","volume":"18","author":"Cohen","year":"2019","journal-title":"BMC Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-19","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1001\/archinternmed.2012.3633","article-title":"The Relief of Existential Suffering","volume":"172","author":"Kissane","year":"2012","journal-title":"Arch Intern Med"},{"key":"10.25259\/IJPC_9_2025\/ref-20","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12904-019-0476-8","article-title":"Palliative Care Training Addressed to Hospital Healthcare Professionals by Palliative Care Specialists: A Mixed-Method Evaluation","volume":"18","author":"Artioli","year":"2019","journal-title":"BMC Palliat Care"},{"key":"10.25259\/IJPC_9_2025\/ref-21","doi-asserted-by":"publisher","first-page":"147","DOI":"10.5737\/23688076302147152","article-title":"Needs of Caregivers of Patients Receiving in-Home Palliative and End-of-Life Care","volume":"30","author":"Pepin","year":"2020","journal-title":"Can Oncol Nurs J"},{"key":"10.25259\/IJPC_9_2025\/ref-22","first-page":"143","article-title":"The Caregiver Role in Palliative Care: A Systematic Review of the Literature","volume":"3","author":"Reigada","year":"2015","journal-title":"Health Care Curr Rev"}],"container-title":["Indian Journal of Palliative Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jpalliativecare.com\/secondary-home-based-palliative-care-impact-on-quality-of-life-of-beneficiaries\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jpalliativecare.com\/secondary-home-based-palliative-care-impact-on-quality-of-life-of-beneficiaries\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T05:20:37Z","timestamp":1752470437000},"score":1,"resource":{"primary":{"URL":"https:\/\/jpalliativecare.com\/secondary-home-based-palliative-care-impact-on-quality-of-life-of-beneficiaries\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,14]]},"references-count":22,"alternative-id":["10.25259\/IJPC_9_2025"],"URL":"https:\/\/doi.org\/10.25259\/ijpc_9_2025","relation":{},"ISSN":["1998-3735","0973-1075"],"issn-type":[{"type":"electronic","value":"1998-3735"},{"type":"print","value":"0973-1075"}],"subject":[],"published":{"date-parts":[[2025,7,14]]},"article-number":"1"}}