Patient and caregiver needs and perspectives during transition to domiciliary palliative care in advanced cancer: a mixed methods study.

The transition from institutional to home-based care is a critical juncture in the palliative care journey for patients with advanced cancer and their caregivers. This phase often has significant physical, emotional, and logistical challenges. Understanding the perspectives of both patients and caregivers during this transition is essential for delivering holistic supportive care that aligns with their values, meets their evolving needs, and improves overall quality of life. Despite its importance, there is limited research addressing the combined needs and experiences of both groups during this period. This study aims to explore the needs, preferences, and experiences of patients with advanced cancer and their primary caregivers at the point of transition to domiciliary palliative care. It adopts a cross-sectional mixed-methods design with quantitative and qualitative components. The qualitative arm will involve semi-structured interviews for which purposive sampling will be done for patients and caregivers with representation of different patients and caregiver factors will be considered to explore their lived experiences. The quantitative component will utilize validated assessment tools to evaluate symptom burden, psychological distress, and caregiver burden. Data will be collected during the transitional phase, either in inpatient or outpatient settings within the department of palliative medicine, to capture immediate perspectives and concerns. By identifying unmet needs and expectations, this study seeks to inform improvements in the continuity and quality of palliative care delivery at home. The findings are expected to guide the development of transition-sensitive practices and support systems, ultimately fostering more responsive and compassionate care. This research has the potential to bridge gaps between hospital and domiciliary care, enhancing support for both patients and their families during the final stages of illness.