Prerequisites and challenges of the role played by death Doula for supporting patients with cancer in end-of-life (EOL) stages: Qualitative study

Abstract

End-of-life (EOL) doulas support dying people and their families. They are a response to the expectations of healthcare professionals (including palliative care providers) in end-of-life situations.The present study aimed to explore the perspective of palliative care team members about the prerequisites and challenges of the role played by death doulas to support patients with cancer in EOL stages. This qualitative study was conducted in 2023–2024 through in-depth semi-structured interviews with 14 healthcare staff. Participants were selected using purposive sampling considering maximum diversity and the study’s inclusion criteria. Conventional content analysis using Lundman and Graneheim’s approach were applied for data analysis. Data analysis revealed two main themes: the prerequisite for establishing the doula role (categories:drivers for shaping the doula role, recruitment and training of doulas, infrastructural preparation) and challenges ahead (categories:patient/family unawareness and lack of formal recognition). Based on the findings, policymakers and planners can develop operational programs to establish the role of death doulas and, by taking anticipated potential challenges into account, formulate preventive strategies. Furthermore, in light of the identified educational gaps, comprehensive educational content can be designed to adequately prepare death doulas for their roles.