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整合姑息治疗的益处:对加纳一家三级医疗机构中姑息治疗提供者观点的质性探索

Benefits of integrating palliative care: a qualitative exploration of the perspectives of palliative care providers in a tertiary health facility in Ghana.

作者信息

Okyere Joshua, Kissah-Korsah Kwaku

机构信息

University Post Office, Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.

Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

Palliat Care Soc Pract. 2023 Mar 29;17:26323524231163199. doi: 10.1177/26323524231163199. eCollection 2023.

Abstract

BACKGROUND

Integration of palliative care (PC) services entails combining administrative, organisational, clinical and service elements to ensure continuity of care between all parties participating in the care network of patients. There is a need to understand the benefits of integrating PC to inform policy making and advance advocacy, especially in resource-constrained settings such as Ghana where PC is sub-optimally implemented. Yet, existing research in Ghana is sparse on what benefits are likely to be experienced as a result of integrating PC.

OBJECTIVE

The study explored service providers' perspectives on the benefits of integrating PC in Ghana.

DESIGN

The design was an exploratory descriptive qualitative research design.

METHODS

A total of seven in-depth interviews were conducted using semi-structured interview guides. The data were managed using NVivo-12. Inductive thematic analysis was carried out following Haase's modification of Colaizzi's approach to qualitative research analysis. The study follows the COREQ guidelines and the ICMJE recommendations.

RESULT

Two main themes emerged: patient-related outcomes, and system/institution-related outcomes. For the patient-related outcomes, the following sub-themes emerged: restored hope, appreciated care and better preparation for the end of life (EoL). The emerging sub-themes under the system/institution-related outcomes include the following: early initiation of care, enhanced communication between primary healthcare providers and the PC team and strengthening staff capacity to provide PC services.

CONCLUSION

In conclusion, there are substantial benefits to be experienced from integrating PC. For the patients, it would restore shattered hopes, result in appreciated care and better preparation for the EoL. For the healthcare system, it would promote early initiation of care, enhance communication between primary healthcare providers and the PC team and strengthen service providers' capacity to provide PC services. This study, thus, furthers the case for a more integrated PC service in Ghana.

摘要

背景

姑息治疗(PC)服务的整合需要将行政、组织、临床和服务要素结合起来,以确保参与患者护理网络的各方之间的护理连续性。有必要了解整合PC的益处,以为政策制定提供信息并推动宣传工作,特别是在像加纳这样资源有限的环境中,PC的实施效果并不理想。然而,加纳现有的关于整合PC可能带来哪些益处的研究很少。

目的

本研究探讨了服务提供者对在加纳整合PC的益处的看法。

设计

采用探索性描述性定性研究设计。

方法

使用半结构化访谈指南进行了总共七次深入访谈。数据使用NVivo-12进行管理。按照哈泽对科拉齐定性研究分析方法的修改进行归纳主题分析。本研究遵循COREQ指南和ICMJE建议。

结果

出现了两个主要主题:与患者相关的结果和与系统/机构相关的结果。对于与患者相关的结果,出现了以下子主题:恢复希望、感激护理以及为生命末期(EoL)做好更好的准备。在与系统/机构相关的结果下出现的新子主题包括:护理的早期启动、初级医疗保健提供者与PC团队之间加强沟通以及增强工作人员提供PC服务的能力。

结论

总之,整合PC会带来诸多益处。对于患者而言,它将恢复破碎的希望,带来感激的护理,并为生命末期做好更好的准备。对于医疗保健系统而言,它将促进护理的早期启动,加强初级医疗保健提供者与PC团队之间的沟通,并增强服务提供者提供PC服务的能力。因此,本研究进一步支持了在加纳提供更综合的PC服务的理由。

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