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加纳癌症患者对专科姑息治疗服务的期望与利用障碍:一项探索性定性研究

Expectations and barriers to the utilization of specialist palliative care services among persons living with cancer in Ghana: an exploratory qualitative study.

作者信息

Mensah Adwoa Bemah Boamah, Poku Abena Agyekum, Mensah Kofi Boamah, Okyere Joshua, Mikare Maurice, Apiribu Felix, Boakye Emelia Osei, Lamptey Joe-Nat Clegg

机构信息

Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, 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 Aug 28;17:26323524231193042. doi: 10.1177/26323524231193042. eCollection 2023.

Abstract

BACKGROUND

The need for palliative care among patients living with cancer is increasing globally. This need is far greater in resource-constrained settings like Ghana where there is a high unmet need for palliative care services. Consequently, there are lapses in the current palliative care regime, thus, resulting in suboptimal utilization.

OBJECTIVE

The study aims to explore patients living with cancer's expectations of palliative care services and examine the barriers that impede palliative care utilization.

DESIGN

Descriptive exploratory qualitative design.

METHODS

A total of 15 patients living with cancer and receiving treatment in a tertiary health facility were purposively sampled to participate in this study. Semi-structured interviews were conducted. The data were transcribed and inductively analysed following Collaizi's qualitative analysis framework.

RESULTS

From the analysis, the findings were grouped under two main categories: perceived expectations and barriers to utilizing palliative care. The participants expected to receive meaningful communication about their condition and prognosis; they also expected to be actively involved in palliative care decision-making. Regarding the barriers, the following themes emerged: financial constraints, unfavourable health appointment schedules, problems with the distance to the health facility, poor referral and follow-up from oncology specialists and being unaware of the availability of palliative care services.

CONCLUSION

In conclusion, there is a need to actively involve patients and their families in all decision-making along the continuum of palliative care service delivery. The study underscores the need for Ghana to implement an integration of palliative care services in primary healthcare facilities to avert the challenges that distance to tertiary healthcare facilities poses to palliative care utilization. Service providers must implement awareness programmes to enable patients to better comprehend palliative care services.

摘要

背景

全球范围内,癌症患者对姑息治疗的需求日益增加。在加纳等资源有限的地区,这种需求更为迫切,因为当地对姑息治疗服务的需求远未得到满足。因此,当前的姑息治疗体系存在缺陷,导致利用效率低下。

目的

本研究旨在探索癌症患者对姑息治疗服务的期望,并调查阻碍姑息治疗利用的障碍。

设计

描述性探索性定性设计。

方法

在一家三级医疗机构中,有目的地抽取了15名正在接受治疗的癌症患者参与本研究。进行了半结构化访谈。数据转录后,按照科莱齐的定性分析框架进行归纳分析。

结果

通过分析,研究结果分为两大类:对姑息治疗的感知期望和利用障碍。参与者期望获得有关其病情和预后的有意义的沟通;他们还期望积极参与姑息治疗决策。关于障碍,出现了以下主题:经济限制、不利的健康预约时间表、到医疗机构的距离问题、肿瘤专科医生的转诊和随访不佳以及对姑息治疗服务可用性的不了解。

结论

总之,有必要让患者及其家属积极参与姑息治疗服务提供全过程的所有决策。该研究强调加纳需要在初级医疗设施中整合姑息治疗服务,以避免距离三级医疗设施过远对姑息治疗利用造成的挑战。服务提供者必须开展宣传项目,使患者能够更好地理解姑息治疗服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2f5/10467251/450380d05531/10.1177_26323524231193042-fig1.jpg

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