Assessment of palliative care service utilization and determinant factors among adult cancer patients in Ethiopia: A systematic review and meta-analysis (PRISMA-compliant)

埃塞俄比亚成年癌症患者姑息治疗服务利用情况及决定因素评估:系统评价和荟萃分析(符合PRISMA规范)

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Abstract

BACKGROUND: Palliative care (PC) improves the quality of life for adult cancer patients by treating their physical, emotional, and spiritual needs throughout the illness progression. However, despite its demonstrated benefits, PC utilization for adult patients with cancer remains low. Therefore, this review aimed to evaluate the prevalence of PC service utilization and determinants for adult patients with cancer in Ethiopia. METHODS: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-2020 checklist guidelines. This study used keywords to search numerous sources, including databases (PubMed and Cochrane Library). Google Scholar and gray literature were also utilized for searching relevant articles. The Joanna Briggs Institute critical appraisal checklist for studies reporting prevalence data was used for assessing the quality of the articles. Potential publication bias was evaluated using a funnel plot and the Egger test. The Statistical Package for the Social Sciences version 29 and Review Manager version 5.4.1 were utilized for the meta-analysis. I2 statistics were employed to assess heterogeneity. RESULTS: The meta-analysis included 11 research articles. The total number of study participants in all included papers was 3405. The overall pooled prevalence of PC utilization among adult patients with cancer was 44.32% (95% confidence interval: 33.33%-55.32%). Age, being a male patient, more than $50 monthly income, educational status of high school and above, patients having family support and caregivers, patient satisfaction with service, and patients' prior knowledge of PC were determinants of PC service utilization among adult patients with cancer. CONCLUSION: This meta-analysis reveals that the pooled prevalence of PC service utilization among adult patients with cancer remains low. Age, being male sex, monthly income, educational status, having family support, service satisfaction, and prior knowledge of the service were determinants of PC service utilization. To improve PC service utilization, a multifaceted approach is needed, focusing on early integration, education, effective communication, caregiver support, integration with oncology care, and community-based service expansion.

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