INTEGRATION OF PALLIATIVE CARE INTO MEDICAL SCHOOL CURRICULUM IN NEPAL – An analytical study among medical students in Nepal

Carlotta Bellon, T. Shah, A. Shah
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Abstract

The holistic approach of palliative care aims at improving the life of patients with life-threatening diseases and their families through early identification, assessment, and treatment of physical, psychological, or spiritual pain. Despite the recognition of palliative care as a human right and essential for the improvement of the quality of life of patients – and their families, many low-income countries either lack palliative care services or have limited access to it. The WHO suggests that one of the steps that countries can take to eliminate these barriers is to include palliative care into the core curricula of all new health professionals. A study in 2019 showed that 58,000 adults required palliative care in Nepal in 2012, and most of them lived in rural areas. Palliative care in Nepal is still new and training programs for doctors and nurses are not fully developed and in place in undergraduate medical schools. This study evaluates the working knowledge of palliative care among undergraduate medical students, and the presence of it in their academic curriculum. This analytical study was designed during an internship at the Binaytara Foundation Cancer Center in Nepal. The study was conducted among undergraduate medical students between March 6th, 2020 to July 6th, 2020. The questionnaire results were entered on Microsoft Excel and then analyzed. Results showed that 63.2% of the respondents had heard of “Palliative Medicine”, but 68.4% did not know the WHO definition of Palliative Care (Table 2 (135189)). Among all the students from the different universities, 33.3% said that palliative care is part of their curriculum, while 66.6% said it is not (Table 5 (135192)). The results from the study demonstrated inadequate knowledge and perception of palliative care among undergraduate medical students in Nepali institutions. The EAPC indications on a palliative care curriculum could be taken as a blueprint for developing a tailored one for medical schools in Nepal to set a strong base for the next generation of doctors to be able to appropriately meet the needs of patients and their families.
将姑息治疗纳入尼泊尔医学院课程——尼泊尔医学生的分析研究
姑息治疗的整体方法旨在通过早期识别、评估和治疗身体、心理或精神上的痛苦,改善患有危及生命的疾病的患者及其家属的生活。尽管人们承认姑息治疗是一项人权,对改善患者及其家属的生活质量至关重要,但许多低收入国家要么缺乏姑息治疗服务,要么获得这种服务的机会有限。世卫组织建议,各国为消除这些障碍可采取的步骤之一是将姑息治疗纳入所有新卫生专业人员的核心课程。2019年的一项研究显示,2012年尼泊尔有5.8万名成年人需要姑息治疗,其中大多数人生活在农村地区。尼泊尔的姑息治疗仍然是新兴的,医生和护士的培训项目还没有完全开发出来,也没有在本科医学院到位。本研究旨在评估医学生对缓和疗护的工作知识,以及缓和疗护在医学生学术课程中的存在。这项分析性研究是在尼泊尔Binaytara基金会癌症中心实习期间设计的。该研究于2020年3月6日至2020年7月6日在医科本科生中进行。将问卷结果输入到Microsoft Excel中进行分析。结果显示,63.2%的受访者听说过“姑息医学”,但68.4%的受访者不知道WHO对姑息治疗的定义(表2(135189))。在来自不同大学的所有学生中,33.3%的人表示姑息治疗是他们课程的一部分,而66.6%的人表示不是(表5(135192))。研究结果表明,在尼泊尔机构的本科医学生对姑息治疗的认识和认知不足。可将EAPC关于姑息治疗课程的指示作为一份蓝图,为尼泊尔医学院制定量身定制的课程,为下一代医生奠定坚实的基础,使他们能够适当地满足病人及其家属的需要。
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