Barriers to accessing palliative care: Perspectives from patients and families

Abstract

Introduction: Access to palliative care is a key component to ensure comprehensive care for patients with advanced chronic diseases and their families. However, several barriers limit its implementation, resulting in unequal and suboptimal care. Objective: To analyze the barriers that patients and families face in accessing palliative care. Methods: A systematic review of publications was carried out in the Scielo, Redalyc, Pubmed, and Dialnet databases using the PRISMA method for selection. Studies referring to the variables and objective set out between 2019 and 2023, in English and Spanish, were included, excluding duplicates with characteristics not corresponding to the scientific method and of little relevance to the topic. 41 articles were selected for analysis. Results: This bibliographic review explores the most common barriers from the perspectives of patients and families, identifying structural factors related to insufficient availability of human resources specialized in palliative care; cultural and psychosocial factors, highlighting the social stigma faced by people with terminal illnesses; in the economic aspect, the influence of the high costs of medications, treatments or services not covered by health systems. In addition, a general lack of knowledge about these services on the part of primary care providers is identified, which affects timely referral. Conclusion: Overcoming these barriers requires comprehensive strategies that include equity-oriented public policies, awareness programs, specialized training for health professionals, and strengthening emotional support for families, ensuring humane and dignified care at the end of life.