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 the 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 that 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.
Highlights
World Health Organization (2014), states that good palliative care improves the quality of life of patients with life-threatening illnesses and their families [1]
The study provided evidence of the challenges and facilitators that influence palliative care that specialists experience while implementing PC
The study setting was in Lusaka, Zambia and targeted 14 palliative care specialists with Diplomas and Degrees in palliative care who were working in the University Teaching Hospital, Cancer Hospital and Kalingalinga Clinic, and were willing to participate in the study
Summary
World Health Organization (2014), states that good palliative care improves the quality of life of patients with life-threatening illnesses and their families [1]. The World Health Organizations’ (WHO) four fundamental pillars for palliative care access include: government policy to improve access, education of health workers and the public, drug availability and implementation throughout health-care systems. Palliative care specialists have a huge role in the implementation of palliative care (Street and Blackford, 2001) [5]. They provide leadership to others so that other clinicians observe and incorporate the practice into their care (Street and Blackford, 2001; Murray et al 2008) [5] [6]. Palliative care implementation includes services such as: symptom control, decision making, management of treatment complications, communication, psychosocial care, and coordination of care (Becker et al 2011; Kulkarni, 2011) [7] [8]
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