尼日利亚姑息治疗面临的挑战：一项跨专业认知的定性研究。

Palliative Care Challenges in Nigeria: A qualitative study of interprofessional perceptions.

机构信息

Departments of Medicine and Medical Education, Feinberg School of Medicine, (A.D.P), Division of Hospital Medicine, Northwestern University, Chicago, Illinois, USA; Center for Global Health Education, Havey Institute for Global Health, Feinberg School of Medicine (A.D.P., D.S., O.F., N.P.,), Northwestern University, Chicago, Illinois, USA.

Center for Global Health Education, Havey Institute for Global Health, Feinberg School of Medicine (A.D.P., D.S., O.F., N.P.,), Northwestern University, Chicago, Illinois, USA.

出版信息

J Pain Symptom Manage. 2023 Jan;65(1):e1-e5. doi: 10.1016/j.jpainsymman.2022.10.002. Epub 2022 Oct 14.

DOI:10.1016/j.jpainsymman.2022.10.002

PMID:36244641

Abstract

CONTEXT

Palliative care awareness, education and practice vary widely across global health systems, especially throughout low- and middle-income countries such as Nigeria. Unfortunately, qualitative investigations into the context, experiences and challenges of Nigerian health care professionals providing palliative care in these settings are still underrepresented in the literature.

OBJECTIVES

The aim of this study was to better understand the perceptions of palliative care providers in Nigeria.

METHODS

The authors conducted an online survey of health professionals caring for patients with palliative care and end of life needs. Survey participants were recruited via convenience sampling from a palliative care training program in Lagos, Nigeria.

RESULTS

27 palliative care program participants (12 physicians, seven nurses, four pharmacists, two psychiatrists and two physiotherapists) responded to the two-question survey. 39 free text responses were collected and analyzed. A majority (33%, n = 13) of responses reported challenges associated with caring for patients with cancer. Suboptimal pain management was the second most common response type (18%, n = 7). Other significant responses included caring for patients with comorbidities (13%, n = 5), patients seeking spiritual care (8%, n = 3) and patients who were unable to afford standard treatment (5%, n = 2). Uncategorized responses (23%, n = 9) included experiences caring for patients with injuries sustained in military operations and COVID-19, among others.

CONCLUSION

These results provide valuable insights into the palliative care experiences and challenges of an interdisciplinary set of health care practitioners providing palliative care in Nigeria. Further research is needed to elucidate the facilitators and barriers of delivering palliative care in similar settings.

摘要

背景

全球卫生系统中，姑息治疗意识、教育和实践存在很大差异，尤其是在尼日利亚等中低收入国家。遗憾的是，在这些环境中为姑息治疗提供服务的尼日利亚卫生保健专业人员的背景、经验和挑战的定性研究在文献中仍然很少。

目的

本研究旨在更好地了解尼日利亚姑息治疗提供者的看法。

方法

作者对照顾有姑息治疗和临终关怀需求的患者的卫生保健专业人员进行了在线调查。调查参与者通过在尼日利亚拉各斯的姑息治疗培训计划，采用便利抽样的方法进行招募。

结果

27 名姑息治疗项目参与者（12 名医生、7 名护士、4 名药剂师、2 名精神科医生和 2 名物理治疗师）回答了两个问题的调查。收集并分析了 39 个自由文本回复。大多数（33%，n=13）回复报告了与照顾癌症患者相关的挑战。其次最常见的回复类型是（18%，n=7）是疼痛管理不理想。其他重要的回复包括照顾患有合并症的患者（13%，n=5）、寻求精神关怀的患者（8%，n=3）和负担不起标准治疗的患者（5%，n=2）。未分类的回复（23%，n=9）包括在军事行动中受伤和 COVID-19 等患者的护理经验。