Palliative care among cancer patients in Georgia: System-level gaps identified through health-related quality of life discrepancies.

BACKGROUND

Palliative care aims to improve health-related quality of life (HRQoL) through holistic, patient-centered approaches. In low- and middle-income countries, including Georgia, care remains largely medically focused, with limited psychological, social, and spiritual support. Discrepancies in HRQoL assessments between patients, families, and healthcare providers may obscure unmet needs and hinder comprehensive care delivery.

DESIGN AND

METHODS

We conducted a multicenter, cross-sectional study across nine palliative care clinics in Georgia from November 2024 to June 2025. HRQoL was assessed using the validated EORTC QLQ-C30 questionnaire, independently completed by 298 cancer patients, their family members (n=298), and 80 healthcare staff.

RESULTS

The QLQ-C30 demonstrated acceptable to excellent internal consistency across all respondent groups. Family members tended to report higher symptom burden and greater functional impairment compared with patient self-reports. Healthcare personnel reported higher functioning levels in emotional, social, and role domains, suggesting potential underestimation of impairments in these areas, while certain symptom domains (pain) were overestimated. Agreement was highest for observable physical symptoms and lowest for psychosocial domains. Despite widespread recognition of the importance of multidisciplinary care, such services were largely absent. Most participants expressed strong support for including psychologists and spiritual care providers, highlighting substantial unmet non-medical needs.

CONCLUSIONS

Integrating perspectives from patients, family members, and healthcare personnel reveals critical gaps in Georgian palliative care. The findings underscore the importance of multi-source HRQoL assessment and culturally adapted, multidisciplinary care models. This evidence can guide public health policy, workforce training, and service design, ultimately improving patient-centered care in Georgia and similar settings.