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Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies
BACKGROUND: Many people live and die in pain in Africa. We set out to describe patient, family and local community perspectives on the impact of three community based palliative care interventions in sub-Saharan Africa. METHODS: Three palliative care programmes in Uganda, Kenya and Malawi were studi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120792/ https://www.ncbi.nlm.nih.gov/pubmed/21569423 http://dx.doi.org/10.1186/1472-684X-10-8 |
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author | Grant, Liz Brown, Judith Leng, Mhoira Bettega, Nadia Murray, Scott A |
author_facet | Grant, Liz Brown, Judith Leng, Mhoira Bettega, Nadia Murray, Scott A |
author_sort | Grant, Liz |
collection | PubMed |
description | BACKGROUND: Many people live and die in pain in Africa. We set out to describe patient, family and local community perspectives on the impact of three community based palliative care interventions in sub-Saharan Africa. METHODS: Three palliative care programmes in Uganda, Kenya and Malawi were studied using rapid evaluation field techniques in each country, triangulating data from three sources: interviews with key informants, observations of clinical encounters and the local health and social care context, and routine data from local reports and statistics. RESULTS: We interviewed 33 patients with advanced illness, 27 family carers, 36 staff, 25 volunteers, and 29 community leaders and observed clinical care of 12 patients. In each site, oral morphine was being used effectively. Patients valued being treated with dignity and respect. Being supported at home reduced physical, emotional and financial burden of travel to, and care at health facilities. Practical support and instruction in feeding and bathing patients facilitated good deaths at home. In each country mobile phones enabled rapid access to clinical and social support networks. Staff and volunteers generally reported that caring for the dying in the face of poverty was stressful, but also rewarding, with resilience fostered by having effective analgesia, and community support networks. CONCLUSIONS: Programmes were reported to be successful because they integrated symptom control with practical and emotional care, education, and spiritual care. Holistic palliative care can be delivered effectively in the face of poverty, but a public health approach is needed to ensure equitable provision. |
format | Online Article Text |
id | pubmed-3120792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-31207922011-06-23 Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies Grant, Liz Brown, Judith Leng, Mhoira Bettega, Nadia Murray, Scott A BMC Palliat Care Research Article BACKGROUND: Many people live and die in pain in Africa. We set out to describe patient, family and local community perspectives on the impact of three community based palliative care interventions in sub-Saharan Africa. METHODS: Three palliative care programmes in Uganda, Kenya and Malawi were studied using rapid evaluation field techniques in each country, triangulating data from three sources: interviews with key informants, observations of clinical encounters and the local health and social care context, and routine data from local reports and statistics. RESULTS: We interviewed 33 patients with advanced illness, 27 family carers, 36 staff, 25 volunteers, and 29 community leaders and observed clinical care of 12 patients. In each site, oral morphine was being used effectively. Patients valued being treated with dignity and respect. Being supported at home reduced physical, emotional and financial burden of travel to, and care at health facilities. Practical support and instruction in feeding and bathing patients facilitated good deaths at home. In each country mobile phones enabled rapid access to clinical and social support networks. Staff and volunteers generally reported that caring for the dying in the face of poverty was stressful, but also rewarding, with resilience fostered by having effective analgesia, and community support networks. CONCLUSIONS: Programmes were reported to be successful because they integrated symptom control with practical and emotional care, education, and spiritual care. Holistic palliative care can be delivered effectively in the face of poverty, but a public health approach is needed to ensure equitable provision. BioMed Central 2011-05-12 /pmc/articles/PMC3120792/ /pubmed/21569423 http://dx.doi.org/10.1186/1472-684X-10-8 Text en Copyright ©2011 Grant et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Grant, Liz Brown, Judith Leng, Mhoira Bettega, Nadia Murray, Scott A Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title | Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title_full | Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title_fullStr | Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title_full_unstemmed | Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title_short | Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies |
title_sort | palliative care making a difference in rural uganda, kenya and malawi: three rapid evaluation field studies |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120792/ https://www.ncbi.nlm.nih.gov/pubmed/21569423 http://dx.doi.org/10.1186/1472-684X-10-8 |
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