Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals
Abstract Background Palliative care improves the quality of life and quality of death, yet in China, existing resources remain largely concentrated in urban areas. Limited access to palliative care exacerbates the sufferings of patients with life-threatening diseases such as cancer in rural regions....
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| Language: | English |
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BMC
2025-07-01
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| Series: | BMC Palliative Care |
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| Online Access: | https://doi.org/10.1186/s12904-025-01848-6 |
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| author | Huijing Lin Yanhua Huang Yunling Wang |
| author_facet | Huijing Lin Yanhua Huang Yunling Wang |
| author_sort | Huijing Lin |
| collection | DOAJ |
| description | Abstract Background Palliative care improves the quality of life and quality of death, yet in China, existing resources remain largely concentrated in urban areas. Limited access to palliative care exacerbates the sufferings of patients with life-threatening diseases such as cancer in rural regions. Objectives This study aimed to explore the facilitators and barriers to palliative care delivery in rural China, based on the perceptions and experiences of rural healthcare professionals. Methods Between July and August 2024, semi-structured interviews were conducted with 25 participants from rural areas, including 18 village doctors and 7 staff from township health centers (5 doctors and 2 nurses). A thematic analysis approach was used to identify key themes and subthemes. Results Three themes were identified, including (1) the necessity of rural palliative care: highlighting the growing population of left-behind older individuals, and poor quality of death in rural areas; (2) facilitators of rural palliative care: including door-to-door service provided by village doctors, close doctor-patient relationships, support from families and neighbors, and care in familiar environment; and (3) barriers of rural palliative care: such as heavy workloads for village doctors, limited professional authority and high perceived legal risk, unbalanced healthcare resources allocation, poor economic conditions, lack of service standards, death-related taboo and stigma, performative filial piety, and limited understanding of palliative care. Conclusion Palliative care in rural China remains underdeveloped. There is an urgent need to establish home-based palliative care services in low-resource regions. Implementing hospital-community-home care model can support more equitable allocation of healthcare resources. Expanding insurance reimbursement and promoting culturally adapted death education may further facilitate the delivery and acceptance of rural palliative care. |
| format | Article |
| id | doaj-art-f46e6d1b0b3b4a3ab8d2df5cdf803b5b |
| institution | Kabale University |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-f46e6d1b0b3b4a3ab8d2df5cdf803b5b2025-08-20T04:02:49ZengBMCBMC Palliative Care1472-684X2025-07-0124111210.1186/s12904-025-01848-6Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionalsHuijing Lin0Yanhua Huang1Yunling Wang2Department of Head and Neck Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Nursing, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Sociology, School of Political Science and Law, University of JinanAbstract Background Palliative care improves the quality of life and quality of death, yet in China, existing resources remain largely concentrated in urban areas. Limited access to palliative care exacerbates the sufferings of patients with life-threatening diseases such as cancer in rural regions. Objectives This study aimed to explore the facilitators and barriers to palliative care delivery in rural China, based on the perceptions and experiences of rural healthcare professionals. Methods Between July and August 2024, semi-structured interviews were conducted with 25 participants from rural areas, including 18 village doctors and 7 staff from township health centers (5 doctors and 2 nurses). A thematic analysis approach was used to identify key themes and subthemes. Results Three themes were identified, including (1) the necessity of rural palliative care: highlighting the growing population of left-behind older individuals, and poor quality of death in rural areas; (2) facilitators of rural palliative care: including door-to-door service provided by village doctors, close doctor-patient relationships, support from families and neighbors, and care in familiar environment; and (3) barriers of rural palliative care: such as heavy workloads for village doctors, limited professional authority and high perceived legal risk, unbalanced healthcare resources allocation, poor economic conditions, lack of service standards, death-related taboo and stigma, performative filial piety, and limited understanding of palliative care. Conclusion Palliative care in rural China remains underdeveloped. There is an urgent need to establish home-based palliative care services in low-resource regions. Implementing hospital-community-home care model can support more equitable allocation of healthcare resources. Expanding insurance reimbursement and promoting culturally adapted death education may further facilitate the delivery and acceptance of rural palliative care.https://doi.org/10.1186/s12904-025-01848-6Palliative careOlderCancerRuralQualitative study |
| spellingShingle | Huijing Lin Yanhua Huang Yunling Wang Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals BMC Palliative Care Palliative care Older Cancer Rural Qualitative study |
| title | Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals |
| title_full | Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals |
| title_fullStr | Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals |
| title_full_unstemmed | Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals |
| title_short | Facilitators and barriers to palliative care delivery in rural China: a qualitative study of the perceptions and experiences of rural healthcare professionals |
| title_sort | facilitators and barriers to palliative care delivery in rural china a qualitative study of the perceptions and experiences of rural healthcare professionals |
| topic | Palliative care Older Cancer Rural Qualitative study |
| url | https://doi.org/10.1186/s12904-025-01848-6 |
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