A study on the role of palliative care in the physical and psychological well-being of people with life-limiting illnesses in Kashmir, India

Living with life-limiting illnesses (LLIs) is psychologically distressing, even more so in areas with a complicated terrain and which are conflict-prone, where insecurity, displacement, and limited healthcare access adds to the burden. In this study, we assessed the impact of palliative care on the psychological well-being of people with life-limiting illnesses in Jammu & Kashmir, a conflict-prone region in India.

This retrospective study analyzed the records of patients with LLIs visiting a pain and palliative care clinic in Srinagar, Jammu & Kashmir, from November 2023 to March 2025. The impact of palliative care on their well-being was assessed twice using the Edmonton Symptom Assessment Scale (ESAS), one week apart, the socioeconomic and disease-related factors associated with a change in scores were also identified. Data were analyzed using Rv4.4.2.

Of the 881 patients included in the analysis, the mean age was 57.6 ± 15.2 years, with almost an equal number above and below 60 years. Males constituted 59.6% of the population. A majority (73.4%) were from Below Poverty Line (BPL) households. Sons were the primary caregivers in 52.5% of the cases, and most (73.2%) of the caregivers were males. The primary diagnosis in almost all (97.6%) was cancer. Statistically significant differences were noted: median pain scores reduced from 7 to 2 (p < 0.001) and total scores reduced from 29 to 20 (p < 0.001) between initial assessment and at follow-up after registration at the palliative care unit. There was no significant difference in median score across age groups, gender and BPL category.

Our study population primarily consisted of patients with malignancies. There was a significant difference in pain score, well-being score, and total ESAS score on follow-up assessment after 1 week of receiving palliative care. No significant difference was seen based on age, gender, socioeconomic status, or diagnosis, highlighting the universal impact of palliative care in people with LLIs.