Quality of life of caregivers of cancer patients is lower compared with the quality of life of caregivers of chronic disease patients. Moreover, no research assessing quality of life of caregivers have been conducted in Central Asia and in Kazakhstan, where lack of trained personnel; limited hospice and palliative beds availability; and underdevelopment of in-home and outpatient day-care services exist.

Aims:

• To assess the state of palliative care in the Republic of Kazakhstan within the past 5 years.
• To assess the effectiveness of palliative care on cancer patients’ and their caregivers’ quality of life, patients’ length of stay, and caregivers’ mental health and bereavement.
• To assess the cost-effectiveness of inpatient hospice-based palliative care services for cancer patients in the Republic of Kazakhstan.

Methods

Sample: Data collection will be conducted in all five hospices across Kazakhstan. A total of 100 hospice patients with clinically terminal cancer will be given consent and asked to fill out the survey with or without help from their family caregivers. In addition, 50 healthcare professionals and 50 family caregivers will be surveyed and interviewed privately in their offices/rooms.  Design: The proposed study will use retrospective and prospective data involving quantitative and qualitative mixed-methods research, where integration of individual semi-structured in-depth interviews, a cross-sectional survey and analyses of existing data will be conducted. The financial impact of palliative care will be estimated using the incremental cost-effectiveness ratio. Finally, to check variations in outcomes under a given set of assumptions, a sensitivity analysis will be conducted.                                                                            

Data collection and analyses: The short form surveys will be administered to assess quality of life of patients and caregivers. The quality-adjusted life years (QALYs) indicator will be calculated using the analyzed results of the survey and the average life expectancy of each participant as obtained from the WHO life-tables. R software, version 3.6.0. (r-project.org) will be used for conducting data checking, cleaning and computing total scores. The NVivo program will be utilized for qualitative analyses. Thus, after coding, a construction of emergent themes will be performed.