Department of Internal Medicine, Makerere University, Kampala, Uganda.
Clinical Trials Research Centre, University of Zimbabwe, Harare, Zimbabwe.
J Pain Symptom Manage. 2022 Dec;64(6):588-601. doi: 10.1016/j.jpainsymman.2022.08.022. Epub 2022 Sep 9.
A challenge facing the provision of palliative care in sub-Saharan Africa is a means of increasing coverage of services whilst maintaining quality. Developing an evidence base that reflects patients' experiences and expectations of palliative care services, the context within which services are provided, and the approaches adopted by services in caring for patients, could facilitate and inform the planning and development of patient-centered and responsive services.
To explore the experiences and expectations of palliative care for people living with advanced cancer in Nigeria, Uganda, and Zimbabwe.
A secondary qualitative analysis of in-depth interviews with 62 people with advanced cancer in Nigeria, Uganda, and Zimbabwe. Framework approach to thematic analysis of transcripts was adopted, focusing on patients' experiences and expectations when interacting with palliative care services, aligning reporting with the COnsolidated criteria for REporting Qualitative research (COREQ).
Four main themes were generated from the analysis: 1) Condition and community as drivers of a multidimensional burden when living with advanced cancer; 2) The expectations and endeavors of palliative care to ameliorate the impact of cancer on physical, psychological and basic needs; 3) Processes and preferences for interacting and communicating with palliative care services, and; 4) Restoration of hope in the context of limited resources.
Wide-ranging physical, psychological, social and financial impacts on participants were outlined. These concerns were largely met with compassionate and responsive care in the context of constrained resources. Study findings can inform evolving notions of patient-centred care for serious illnesses in the participating countries.
在撒哈拉以南非洲地区，提供姑息治疗所面临的一个挑战是，如何在保持服务质量的同时，增加服务的覆盖范围。建立一个反映患者对姑息治疗服务的体验和期望、服务提供背景以及服务在照顾患者方面所采用的方法的证据基础，可以促进和为以患者为中心、有回应性的服务的规划和发展提供信息。
探讨尼日利亚、乌干达和津巴布韦的晚期癌症患者对姑息治疗的体验和期望。
对尼日利亚、乌干达和津巴布韦的 62 名晚期癌症患者进行深入访谈的二次定性分析。采用框架方法对转录本进行主题分析，重点关注患者在与姑息治疗服务互动时的体验和期望，报告内容符合定性研究报告的统一标准（COREQ）。
从分析中产生了四个主要主题：1）条件和社区是晚期癌症患者面临多维负担的驱动因素；2）姑息治疗减轻癌症对身体、心理和基本需求影响的期望和努力；3）与姑息治疗服务互动和沟通的过程和偏好；4）在资源有限的情况下恢复希望。
研究参与者概述了广泛的身体、心理、社会和经济影响。在资源有限的情况下，这些问题主要通过富有同情心和响应性的关怀得到满足。研究结果可以为参与国家不断发展的严重疾病以患者为中心的护理理念提供信息。
