**3.2 The factors should be addressed under palliative care for the betterment of quality of life in patients**

In 2011 Jacoba et al. [25] studied the effect of palliative care in a resource poor community in South Africa, with the themes of:

a.the factors that had a positive influence on quality of life,

b.factors that had a negative influence on quality of life

c. experience of quality of life.

In their study, it is observed that: being able to work as a very important factor for all the participants involved in the study, as it keeping them busy and having no time to spend for unnecessary worries in addition to help in earnings. Support from friends and family as well as health care professionals was another major factor contributing for the improvement of quality of life. Spiritual activities such as going to church, participating church services, singing in choir and prayers made the participants to feel strong and comfort and gave them a feel of "alright". Lastly, comes the symptom control. The poverty was the predominant negative factor on the quality of life of the study participants. Other negative factors were unemployment, separation from children, rejection and stigmatization and experiencing the symptoms with pain as mostly described symptom. It is observed that uplifting of education and economic status of the community will help for the improved psycho-social support extending to the terminally ill patients and there by their quality of life [52].
