Table 4.

Illustrative participant quotations for inductive PCC themes (for more in-depth table of inductive themes and illustrative quotations see online supplemental table 3)

Inductive theme		Illustrative quotations
Collectivism
Benefits of a support system and positive relationships on well-being The importance of relationships Interdependence of well-being Value of condition-specific patient and family support groups	78	I have a group of friends who would pull me out of the hole every time I felt depressed and they keep telling me what a fighter…I am. Support groups are very important for cancer patients. PKH0017, Patient, Male, 49, Jordan
	79	These patients really need quite a lot of support because they are so dependent on those who are around them and what is happening around them. PROF07-004, HCP, Male, 50, South Africa
	80	I always come here with my family so I don’t feel stressed. My daughter can manage everything for me…where to contact and where to go. 1006, Patient, Female, 58, Thailand
	81	Interviewer: Are you afraid of death? Patient: No, I am afraid I might leave my children). PKH0030, Patient, Female, 33, Jordan
	82	I think I have grown too fast, maybe 20 years older than I should be, I am responsible for everything in the house, my father feels like a son to me, I would be measuring his temperature or blood pressure. CAL0005, Caregiver, Female, 27, Jordan
	83	The interesting thing is their families are quite frustrated with them. And I think they get a lifetime of dad being rude, irritable, maybe contributing to often quiet, sad broken homes. PROF04-001, HCP, Female, 39, South Africa
	84	It would be nice if we could help each other. For us too to help. To have something that we do in order to show other people that even us, we can do this, we just need to persevere. Yes, for us to persevere and not lose hope. PAT04-002, Patient, Male, 38, South Africa
	85	Their decisions depend on their relatives, not them. Patients will choose to do things that would not be a burden to their relatives. For example, patients who have to come to hospital often don’t want to come because they don’t want their relatives to take leave from work. 3007, HCP, Female, 27, Thailand
Bringing services into the local community or home
Patient not wanting to be admitted/spend long periods in hospital Drawing on other human resources in community for example, health promoters or volunteers; traditional health workers; support from community or religious organisations Creating a health-promoting home environment	86	I would tell him I don’t want to be admitted…because I had recently moved to a new place and I want to stay with my children, and I would ask him if I can just take the chemo and go home. PKH0030, Patient, Female, 33, Jordan
	87	We start preparing the patient from the day of admission to the discharge. We get the equipment and with donations from the social worker, we get the proper mattress and generator and whatever else needs to be ready at their homes. HCP8, HCP, Male, 30, Jordan
	88	If we can get a multi-pronged approach, where we have social workers, homecare-based carers, we have home visits, we have social workers able to actually go to the communities and see what is available in the community and upskill those people, that will be very useful. PROF01-002, HCP, Male, 45, South Africa
	89	I think if they say we are struggling at home, we have the home-based care systems that the sisters come around but it is unfortunately also not an everyday support system. PROF01-008, HCP, Female, 26, South Africa
	90	Home visits will help us better follow up with patients’ symptoms. Relatives of bedridden patients will have trouble bringing the patients to the hospital. If we can pay a home visit, it would be convenient for them. 3009, HCP, Female, 21, Thailand
	91	A village volunteer’s visit would be nice to help patients. If the patient’s condition worsens, there would be someone to inform the relatives to take the patient to the hospital. 1010, Patient, Female, 60, Thailand
Equity and non-discrimination
Wish to be treated with equal respect and care irrespective of socioeconomic status Ensure services are accessible and understandable by persons of all socioeconomic backgrounds, nationalities and ages Underprivileged patients and families in need of additional social support Patients and carers wish for most urgent cases to be prioritised Impacts of pre-existing relationship between patient and HCP Carefulness required when communicating with people of diverse ethnicities/nationalities Sex and gender impacts a) communication between HCPs and patients or family members b) impacts of illness on a person’s life	92	They don’t have to stick to the line, they should let in patients who have a more serious condition that others. PKH0016, Patient, Female, 63, Jordan
	93	Sometimes I think it is how much you earn and how much money you get in your bank account…I think if you have lots of money, people will help you with respect. If you got less, they treat you like nothing sometimes. CAR03-008, Caregiver, Female, 39, South Africa
	94	I think more emphasis in identifying patients who need more help. PROF01-001, HCP, Female, 30, South Africa
	95	I am at an advantage because I know someone who knows someone…when I come to the clinic it’s about who I know. That will determine whether or not I will be seen or assisted. CAR04-002, Caregiver, Female, 26, South Africa
	96	If the doctor talks about other things with the patients, it will slow down the patient’s examination. Other patients are waiting, so I have to be considerate. 1010, Patient, Female, 60, Thailand
	97	The law here states that foreigners are charged more than citizens, so it is not discrimination, it is just the law. CAL0017, Caregiver, Male, 41, Jordan
	98	(Patients) have different education and socioeconomic backgrounds. They should have some knowledge so that they can understand this kind of service system. I think that doctors, nowadays, have improved in their communication skills so they can talk to patients. 1005, Patient, Male, 52, Thailand
	99	I’m not good at communicating via the Internet like this clinic does as I'm old-school and not good with computers. 1007, Patient, Male, 60, Thailand
	100	There’s a lot of socialization during the visits. You’re discussing things with someone from a different culture and you both have your questions. HCP06, HCP, Female, 31, Jordan
	101	I like the Afrikaans doctors because they understand me better. [I can speak] my language. So, I cannot say that the foreign doctors are incapable of doing that. They are capable of doing their job but sometimes you just feel like they do not examine you nicely because you do not tell them. PAT03-001, Patient, Male, 42, South Africa
	102	I come from a masculine family, as all of my 7 brothers are older than me. They had all the power and us the girls, we had no opinion. PKH0012, Patient, Female, 50, Jorda
	103	Another thing that upsets me is that I don’t get my period anymore, so it feels like my life is over…I really like kids but now even if I decided to get married, I won’t be able to have kids. Nobody is gonna want a woman with cancer, let’s be realistic. PKH0020, Patient, Female, 42, Jordan
Context of limited resources
Limited financial and human resources for health services impacts ability to provide PCC Limited personal resources of patients and families—poor housing and employment conditions contributing to poor health and well-being Patients using health financial assistance or selling therapeutic equipment to cover basic living expenses Material realities impose constraints on patient ability to engage or adhere Adjusted preferences and expectations	104	I end up taking it upon myself to provide these services including coordination, palliation, radiotherapy, chemotherapy, and spiritual support as well. I end up feeling unsatisfied with myself thinking that I haven’t done enough, when in reality I can’t. HCP13, HCP, Male, 35, Jordan
	105	There would be some policy, financial, personnel, and equipment issues (to provide better care). Not all hospitals have the necessary resources. 2009, Caregiver, Female, 45, Thailand
	106	I stopped the treatment for financial reasons. PAL0006, Patient, Male, 68, Jordan
	107	Our housing system is not alright, some of these patients are coming from informal settlements. So, it’s crowded…so even if moss I don’t smoke, if next door there is smoking. PROF03-002, HCP, Female, 28, South Africa
	108	Some of the patients sell their pumps to get money and then they come back to the facility, tight chest and we need to give them another pump.” PROF07-003, HCP, Female, 55, South Africa
	109	People are going to say you have to eat healthy and then a lot of people are going to say but how are we going to eat healthy because it is reality you have to eat what you have…nowadays living healthy is very expensive. CAR03-011, Caregiver, Female, 42, South Africa
	110	We should know about personal information that might affect patients’ condition such as their jobs because certain jobs can trigger a relapse. 3009, HCP, Female, 21, Thailand
	111	Some patients have to take medicines that are not covered by the Universal Health Coverage Scheme. Some [ask] us whether they could stop taking that medicine…because it was so expensive. 3006, HCP, Male, 24, Thailand
	112	Patient’s satisfaction rate is excellent because as I told you we serve a category of people that are mostly livening a simple lifestyle, they don’t require luxurious treatment, they need core simple services that can simply satisfy them and make them happy, such as, doctors, nurses, pharmacy and scans. HCP16, HCP, Male, 35, Jordan
	113	You have to answer questions from scratch about medical history which can get annoying, but then you are not going to be annoyed because now you are getting a free service. CAR04-002, Caregiver, Female, 26, South Africa
Healthcare workforce well-being
Overstretched and under-staffed Criticism or verbal abuse from patients Psychological challenges of working with end-of-life patients	114	It’s also exhausting to see 15 palliative care patients on the same day. You need to rest in between patients and recharge so you can provide the best service. HCP12, HCP, Female, 28, Jordan
	115	Sometimes we give more than we take. My salary is 320 JD and I get 100 JD incentives every 3 months. I worked 100 times worth that salary for 10 years. CKH0009, Caregiver (and nurse), Female, 44, Jordan
	116	I would like to hear about the experiences of my colleagues in the same field. Did they experience the same things I did? Are my feelings normal?…Emotional support is the most important thing we as healthcare providers require. HCP4, HCP, Female, 31, Jordan
	117	I just feel that a person brought his/her problem from the house…Now s/he is out of control. There is exhaustion. The pressure is high. CAR04-001 Caregiver, Female, 48, South Africa
	118	Even if the psychological support existed in a more formal in-depth way, I am not sure how well it would be utilised because just there is work to be done and sometimes I will just carry on because I would rather get home at a normal home going time. PROF01-005, HCP, Male, 32, South Africa
	119	I used to give patients my personal Line contact in case they needed medical advice. It turned out to be too much for me. They were not considerate. When I could not help, I got criticism. ID3007, HCP, Female, 27, Thailand
	120	I think some staff may need to see a psychiatrist in order to vent their feelings so that they can smile when they see patients…and see…how much they help other people. ID 2005, Caregiver, Female, 50, Thailand

HCP, healthcare professional; PCC, person-centred care.