Abstract
Most clinicians receive little or no palliative care (PC) education. Similarly, patients and their families receive little or no information on PC. Our study explored education in PC, while examining for its impacts on service delivery and utilization from the perspective of health care professionals (HCPs), patients, and their families. An ethnographic approach was utilized to gather data from 41 participants. Spradley’s ethnographic analytical framework guided data analysis. Two themes identified were inadequate HCPs’ knowledge base and impact of service-users’ inadequate health education. The findings show that most HCPs had no formal education in PC, attributed to the lack of PC residency programs and the absence of educational institutions that provide such education. Patients and families also conveyed poor understandings of their illness and palliation, rooted in the HCP culture of partial disclosure of information about their diagnosis, care, and prognosis. Findings suggest a cultural shift that supports PC education for professionals is required to promote realist medical approach in the care for patients with life-limiting illnesses.
Highlights
Palliative care (PC) helps patients die a “good death” in comfort, with their social, spiritual, and religious needs taken into account (Economist Intelligence Unit [EIU], 2015) and often in their preferred place of death (Ali et al, 2019)
Competency in PC could be attained through formal theoretical teaching and mentored clinical exposure, but very little formal PC education among the health care professionals (HCPs) was identified in the data as indicated in the following extract: Only two nurses among all the members of the palliative care team received six weeks training in palliative care at Uganda. (PC Doctor 1)
I am employed to work in another department but I volunteered to work in palliative care unit because of my interest in palliative care. (PC Doctor 1)
Summary
Palliative care (PC) helps patients die a “good death” in comfort, with their social, spiritual, and religious needs taken into account (Economist Intelligence Unit [EIU], 2015) and often in their preferred place of death (Ali et al, 2019). In Africa, PC education and, specialists in PC are severely limited (Clark et al, 2019; Van der Plas et al, 2020; World Health Organization, 2018). Some African countries such as Uganda, South Africa, Kenya, Botswana, Zambia, Malawi, and Tanzania have made progress through either developing PC educational center or implementing national PC program in conjunction with local universities (Hannon et al, 2016). Such phenomena appear not to exist in Nigeria
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