Expert Perspectives on Integrating Palliative Care into Primary Health Care: A Qualitative Analysis of a Modified Delphi Study.

Background: Integrating palliative care (PC) into primary health care (PHC) is essential for achieving Universal Health Coverage and reducing avoidable suffering. Despite global progress in PC development, the extent to which PC is effectively embedded within PHC systems remains unclear, particularl...

Descripción completa

Detalles Bibliográficos
Publicado en:Nursing Reports Vol. 16; no. 1; pp. 20 - 36
Autores principales: Muñoz Olivar, Carolina, Marquez-Doren, Francisca, Gómez Quintero, Juan Sebastián, Toro, Carla Taramasco, Avendaño-Vásquez, Carlos Javier
Formato: research tables/charts Journal Article
Publicado: MDPI Jan2026
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191217484&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 191217484
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        2039439X
        EGNT
      jtl: Nursing Reports
      issn: 2039439X
      maglogo: N
    pubinfo:
      dt: Jan2026
      vid: 16
      iid: 1
      pid: 97109
      pub: MDPI
    artinfo:
      ui:
        191217484
        191217484
        191217484
        10.3390/nursrep16010020
        191217484
      ppf: 20
      ppct: 16
      formats:
        fmt:
          – @attributes:
              type: T
          – @attributes:
              type: P
      tig:
        atl: Expert Perspectives on Integrating Palliative Care into Primary Health Care: A Qualitative Analysis of a Modified Delphi Study.
      aug:
        au:
          Muñoz Olivar, Carolina
          Marquez-Doren, Francisca
          Gómez Quintero, Juan Sebastián
          Toro, Carla Taramasco
          Avendaño-Vásquez, Carlos Javier
        affil: Health Sciences, Faculty of Medicine, Antonio Nariño University, Bogotá 111321, Colombia
      sug:
        subj:
          Palliative Care Colombia
          Primary Health Care Colombia
          Health Care Delivery, Integrated
          Expert Clinicians Psychosocial Factors
          Attitude of Health Personnel
          Human
          Funding Source
          Colombia
          Female
          Male
          Adult
          Middle Age
          Qualitative Studies
          Delphi Technique
          Thematic Analysis
          Conceptual Framework
          Data Analysis Software
          Public Health
          Health Services Accessibility
          Health Policy
          Rural Areas
          Workforce
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Integrating palliative care (PC) into primary health care (PHC) is essential for achieving Universal Health Coverage and reducing avoidable suffering. Despite global progress in PC development, the extent to which PC is effectively embedded within PHC systems remains unclear, particularly in low- and middle-income countries. Colombia illustrates this gap, with an advanced legal framework but persistent territorial inequities. This study explored how national experts conceptualize PC integration into PHC to inform the development of context-sensitive indicators. Methods: A directed thematic analysis was conducted using qualitative comments from a modified Delphi process (pre-Delphi, Round 1, Round 2). Coding was guided by the WHO model for PC development and the WHO–UNICEF Operational Framework for PHC, combining deductive and inductive approaches to identify recurrent themes. Results: A total of 230 qualitative comments from experts in PC, PHC, and public health were analyzed. Experts described integration as the alignment of policy, education, service delivery, and community participation within PHC structures. They emphasized that laws and training programs alone are insufficient; integration depends on implementation capacity, equitable access, and locally responsive systems. Rural areas were identified as facing the greatest barriers, including limited trained staff, restricted medicine availability, and weak referral pathways. Conclusions: Experts understood PC integration into PHC as a dynamic and ethical process linking system design with human experience. Strengthening equity, workforce preparation, and community engagement is essential to translate policy into practice and to develop meaningful indicators for health system improvement.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N