• Frank Elsner, Johanna Schmidt, M R Rajagopal, Lukas Radbruch, and Martina Pestinger.
• Department of Palliative Medicine, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany. felsner@ukaachen.de
• Future Oncol. 2012 Sep 1;8(9):1183-91.

AimTo investigate psychosocial and spiritual problems of terminally ill patients in Kerala, India.Materials & MethodsSemi-structured qualitative interviews of terminally ill patients were carried out at the Trivandrum Institute of Palliative Sciences Palliative Care Clinic in Trivandrum, Kerala, India and in patients' homes in the surrounding area.ResultsInterviews with 37 terminally ill patients in Kerala showed several problems regarding their emotional state, faith, knowledge about the disease, family life and the major impact of financial issues.ConclusionThis study shows that more effort should be focused on the reduction of the problems terminally ill patients have to face. While many of these problems are a result of financial troubles and could be eliminated if sufficient funds were available, others are a consequence of tradition and culture. Solutions for the improvement of patients' situations in accord with tradition and culture have to be found.

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