Strategi Penerapan Rural Palliative Care Berdasarkan WHO Six Building Blocks : Studi Kualitatif Pada Perawat Di Wilayah Rural

Abstract

Background: Palliative care is a comprehensive approach to improving the quality of life for patients with chronic or terminal illnesses. However, the implementation of palliative care in rural areas still faces various limitations. Objective: This study aims to explore nurses' strategies in implementing rural palliative care based on the WHO Six Building Blocks framework in Jember Regency. Methods: The study used a descriptive qualitative design. Twelve nurses were selected using purposive sampling, with data collected through in-depth interviews and analyzed using thematic analysis. Results: The study identified six main themes: (1) implementation of service- and family-based palliative care, (2) development of nurse competency and management, (3) utilization of hospital management information systems, (4) management of facilities and medications, (5) patient financial assistance, and (6) policy-based coordination and leadership. Nurses implemented various adaptive strategies to address resource limitations, such as optimizing the role of the family, team collaboration, utilization of technology, and cross-sector coordination. Conclusion: This study shows that palliative care in rural areas is still adaptive to limitations, thus requiring strengthening of a more integrated health system, especially in the aspects of policy, resources, and development of community-based services.