The Experience of Palliative Care Specialists in Implementing Palliative Care into their Work Settings in Lusaka, Zambia

Patience Mbozi, E. Namukwaya, Joseph Chaila
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引用次数: 2

Abstract

There is a significant unmet need for palliative care globally: of the 58 million people dying annually, it was estimated that at least 60% will have a prolonged advanced illness and dying and would benefit from palliative care. Zambia has a total population of 15,066,266 people. About 1,150,400 people are living with HIV and 18,900 people were reported to have died of HIV in 2014 alone. The most recent palliative care situational analysis in Zambia highlighted that palliative care remained ‘an essential absent factor’ and revealed that there were gaps in the type of care given in various home based care (HBC) programs. Therefore, this study aimed at exploring the experiences of trained palliative care specialists in implementing palliative care in Lusaka, Zambia. This study was an exploratory qualitative research. The population comprised of the trained palliative care specialists in either degree or diploma in palliative care, working in Lusaka. Purposive sampling was used and the sample totaled 6 (n-6). The data collection was done using a semi-structured interview guide, through face-to-face in-depth interviews. The interviews lasted for an average of 20 minutes. Prompts and probes were used to increase detailed analysis explorations Eleven themes broadly classified as facilitators or challenges emerged from the study. Among the facilitators: training influence; higher level support; effective team work and delivery models; and personal development and motivation to serve. challenges included: lack of PC knowledge; lack of essential medication for PC; work burden; lack of financial resources; lack of acceptance of PC; lack of PC guidelines; and legal restrictions on the use of opioids. The study provided evidence of the challenges and facilitators that influence palliative care specialists experience while implementing PC. It is therefore, recommended that more research, education, effective teamwork is promoted as the study revealed that participants needed support for effective implementation of palliative care.
在赞比亚卢萨卡,姑息治疗专家在他们的工作环境中实施姑息治疗的经验
在全球范围内,对姑息治疗的需求仍未得到满足:在每年死亡的5800万人中,估计至少有60%将患有长期晚期疾病和死亡,并将受益于姑息治疗。赞比亚总人口为15,066,266人。据报道,仅2014年就有1150400人感染艾滋病毒,18900人死于艾滋病毒。赞比亚最近的姑息治疗情况分析强调,姑息治疗仍然是一个必不可少的缺席因素,并揭示了在各种家庭护理(HBC)项目中所提供的护理类型存在差距。因此,本研究旨在探索训练有素的姑息治疗专家在赞比亚卢萨卡实施姑息治疗的经验。本研究为探索性质的研究。人口包括在卢萨卡工作的经过培训的姑息治疗专家,具有姑息治疗学位或文凭。采用有目的抽样,共抽样6例(n-6)。数据收集采用半结构化访谈指南,通过面对面的深度访谈完成。面试平均持续20分钟。提示和探针被用来增加详细的分析探索,甚至被广泛归类为促进因素或挑战的主题也从研究中出现。促进因素中:培训影响;更高层次的支持;有效的团队合作和交付模式;个人发展和服务的动机。挑战包括:缺乏PC知识;缺乏治疗PC的基本药物;工作负担;缺乏财政资源;缺乏对PC的接受;缺乏个人电脑指南;以及对阿片类药物使用的法律限制。该研究提供了在实施PC时影响姑息治疗专家经验的挑战和促进因素的证据。因此,建议进行更多的研究、教育和有效的团队合作,因为研究表明参与者需要支持才能有效实施姑息治疗。
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