Tag Archives: palliative care

Palliative Care in Africa special issue

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“Palliative care is important because the pain in cancer is akin to torture,” says Professor Merriman, Founder of Hospice Africa Uganda and Guest Editor of this special issue. “We have known how to control pain since 1967, yet less than 3% of people in Africa have their pain controlled.”

Contributors from Sudan, Nigeria, Rwanda and Uganda describe a hopeful continent in which older societal beliefs, family traditions, government policy and modern healthcare combine to meet the challenges of palliative care. Many African nations share a strong cultural suspicion of opioid medications, including morphine. Healthcare professionals may be wary of prescribing painkillers, due to a common misapprehension that they will encourage patients to become addicted to drugs. Taken together, the papers represent a cross-section of palliative care efforts in Africa in the past twenty years – and a powerful vision for the movement’s future.

Read this special issue for free.  http://ecancer.org/special-issues/6-palliative-care-in-africa.php

Access ecancer’s free Palliative care elearning course for healthcare professionals in Africa.

http://ecancer.org/education/course/1-palliative-care-e-learning-course-for-healthcare-professionals-in-africa.php

HIFA profile: Katie Foxall is Publishing Manager at eCancer, Bristol, UK. katie AT ecancer.org

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To send a message to the HIFA forum, simply send an email to: HIFA2015@dgroups.org

A qualitative study: potential benefits and challenges of traditional healers in providing aspects of palliative care in rural South Africa

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Citation: Campbell LM, Amin NN.  A qualitative study: potential benefits and challenges of traditional healers in providing aspects of palliative care in rural South Africa. Rural and Remote Health 14: 2378. (Online) 2014. Available: http://www.rrh.org.au

ABSTRACT

Introduction:  This article draws on selected palliative care providers’ views and experiences to reflect on the potential benefits and possible challenges of involving traditional healers in palliative care in rural areas of South Africa. There is increasing consensus that palliative care should be offered by a range of professional and non-professional healthcare givers. Including non-professionals such as traditional healers in a palliative care team may strengthen care provisioning as they have intimate knowledge of patients’ local culture and spiritual beliefs.

Methods:  Employing the qualitative method of photo-elicitation, one-on-one discussions about the photographs taken by participants were conducted. The participants – 4 palliative care nurses and 17 home-based care workers – were purposively selected to provide in-depth information about their experiences as palliative caregivers in rural homes.
Results:  Healthcare workers’ experiences revealed that the patients they cared for valued traditional rituals connected to illness, dying, death and bereavement. Participants suggested that traditional healers should be included in palliative care training programs as they could offer appropriate psychological, cultural and spiritual care. A challenge identified by participants was the potential of traditional healers to foster a false sense of longevity in patients facing death.
Discussion:  The importance of recognising the value of traditional practices in palliative care should not be underrated in rural South Africa. Traditional healers could enhance palliative care services as they have deep, insider knowledge of patients’ spiritual needs and awareness of cultural practices relating to illness, death, dying and bereavement. Incorporating traditional healers into healthcare services where there are differences in the worldviews of healthcare providers and patients, and a sensitivity to mediate cultural differences between caregivers and patients, could have the benefit of providing appropriate care in rural spaces.
Conclusions:  Considering the influences of cultural and spiritual beliefs on the wellbeing of patients living in rural areas, the inclusion of traditional healers in a palliative care team is a sensible move. It is, nevertheless, important to note that unanticipated challenges may arise with respect to power differentials within the palliative care team and to beliefs that contradict medical prognosis.

Understanding the distinct experience of rural interprofessional collaboration in developing palliative care programs

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Citation: Gaudet A, Kelley M, Williams AM.  Understanding the distinct experience of rural interprofessional collaboration in developing palliative care programs. Rural and Remote Health 14: 2711. (Online) 2014. Available: http://www.rrh.org.au

ABSTRACT

Introduction:  Palliative care is one component of rural generalist practice that requires interprofessional collaboration (IPC) amongst practitioners. Previous research on developing rural palliative care has created a four-phase capacity development model that included interprofessional rural palliative care teams; however, the details of rural team dynamics had not been previously explored and defined. A growing body of literature has produced models for interprofessional collaborative practice and identified core competencies required by professionals to work within these contexts. An Ontario College of Family Physicians discussion paper identifies seven essential elements for successful IPC: responsibility and accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect. Despite the fact that IPC may be well conceptualized in the literature, evidence to support the transferability of these elements into rural health care practice or rural palliative care practice is lacking. The purpose of this research is to bridge the knowledge gap that exists with respect to rural IPC, particularly in the context of developing rural palliative care. It examines the working operations of these teams and highlights the elements that are important to rural collaborative processes.

Methods:  For the purpose of this qualitative study, naturalistic and ethnographic research strategies were employed to understand the experience of rural IPC in the context of rural palliative care team development. Purposive sampling was used to recruit key informants as participants who were members of rural palliative care teams. The seven elements of interprofessional collaboration, as outline above, provided a preliminary analytic framework to begin exploring the data. Analysis progressed using a process of interpretive description to embrace new ideas and conceptualizations that emerged from the patterns and themes of the rural health providers’ narratives. The questions of particular interest that guided this work were: What are the collaborative processes of a rural palliative care team? To what extent are the seven elements of IPC representative of rural teams’ experiences? Are there any additional elements present when examining the experiences of rural teams?
Results:  The analysis showed that the seven identified elements of IPC were very much integrated in rural teams’ collaborative practice, and thus validated the applicability of these elements in a rural context. However, all seven elements were implemented with a rural twist: the distinctiveness of the rural environment was observed in each element. In addition, another element, specific to rural context, was observed, that being the ‘automatic teams’ of rural practitioners – the collaboration has been established informally and almost automatically between rural practitioners.
Conclusions:  This research contributes new knowledge about rural palliative care team work that can assist in implementing models for rural palliative care that apply accepted elements of collaborative practice in the rural context. Understanding the process of how rural teams form and continue to function will help further the current understanding of IPC in the context in which these professionals work.