Department of Sociology/Anthropology, University of Nigeria, Nsukka, Nigeria.
IVAN Research Institute, Enugu, Nigeria.
BMC Palliat Care. 2024 Sep 17;23(1):227. doi: 10.1186/s12904-024-01558-5.
Women living with HIV (WLWH) in low- middle-income countries (LMICs) face increased mortality risks from comorbidities despite progress in antiretroviral therapy. Palliative care (PC) is vital for these patients, yet its integration in LMICs, such as Nigeria, is suboptimal due to unique challenges.
This study investigated the knowledge, perceived barriers, and facilitators influencing PC integration into routine HIV care within healthcare (HC) settings.
A cross-sectional survey was conducted among WLWH in twelve HC facilities throughout Nigeria. Data collection involved surveys focused on PC knowledge, attitudes, facilitators, and barriers. Logistic regression analyses were employed to examine the data.
This study revealed significant gaps in knowledge and attitudes towards PC among HIV + women at NISA-MIRCs. Over 90% were unaware of PC services, but many saw its potential to offer hope (55%) and improve quality of life (56.5%). The key predictors of PC knowledge included education, occupation, religion, having fewer children, urban residence, type of residence, and having a high income (p < .05). Despite the willingness to access PC, barriers such as negative HC worker attitudes, perceived high cost, and limited decision autonomy could hinder integration. Facilitators included low-cost services, positive HCW attitudes, physician recommendations, and perceived necessity for personal well-being.
Knowledge gaps, diverse attitudes, and significant barriers highlight the need for targeted PC interventions for WLWH. Tailoring educational programs, addressing cost barriers, and improving healthcare infrastructure are crucial to enhancing PC accessibility and quality. These findings can guide policymakers and HC practitioners toward more effective and inclusive care strategies.
尽管抗逆转录病毒疗法取得了进展,但中低收入国家(LMICs)的艾滋病毒感染者(PLWH)仍面临着因合并症而导致死亡率增加的风险。姑息治疗(PC)对这些患者至关重要,但在尼日利亚等 LMIC 中,由于存在独特的挑战,其整合情况并不理想。
本研究调查了影响姑息治疗在医疗保健(HC)环境中纳入常规艾滋病毒护理的知识、感知障碍和促进因素。
在尼日利亚的 12 个 HC 设施中,对 PLWH 进行了横断面调查。数据收集包括针对姑息治疗知识、态度、促进因素和障碍的调查。采用逻辑回归分析来分析数据。
本研究表明,NISA-MIRCs 的 HIV 阳性妇女对姑息治疗的知识和态度存在显著差距。超过 90%的人不知道姑息治疗服务,但许多人认为姑息治疗有可能提供希望(55%)并改善生活质量(56.5%)。姑息治疗知识的主要预测因素包括教育程度、职业、宗教信仰、子女较少、城市居住、居住类型和高收入(p < 0.05)。尽管愿意接受姑息治疗,但仍存在一些障碍,如 HC 工作人员的消极态度、认为费用高、决策自主权有限等,可能会阻碍姑息治疗的整合。促进因素包括低成本服务、HCW 的积极态度、医生的建议以及对个人幸福感的必要性的认识。
知识差距、多样化的态度和显著的障碍突出表明,需要为 PLWH 提供有针对性的姑息治疗干预措施。调整教育计划、解决费用障碍以及改善医疗保健基础设施对于提高姑息治疗的可及性和质量至关重要。这些发现可以为政策制定者和 HC 从业者提供指导,以制定更有效的和包容性的护理策略。