Experiences of nurses practising home-based palliative care in a rural South African setting

Abstract

Home-based care is necessary in rural South Africa owing to the impact of the HIV/AIDS epidemic, inaccessible health-care institutions, and overcrowding in hospitals. Palliative care has been introduced as part of home-based care and there is a call for research to inform practice, training, and support of caregivers. This exploratory paper reports on four nurses' experiences of providing home-based palliative care (HBPC) in rural KwaZulu-Natal. The study employed the qualitative method of photo-elicitation, which was used as a launching point for individual one-to-one interviews with the participants. HBPC increases access to care and provides a means of humanizing care and supporting patients in familiar community structures. It also enables nurses to practise independently and facilitates practise of traditional customs and use of traditional medicines. Challenges include patients' understanding of palliative care and nurses being placed at risk. The study uncovered several benefits to HBPC for patients and nurses, but also highlighted various challenges in its implementation. Further research is needed before any recommendations for practice, training, and support can be made.