Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

Curationis ◽  
2014 ◽  
Vol 37 (1) ◽  
Author(s):  
Nokwanda E. Bam ◽  
Joanne R. Naidoo
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Interdisciplinary Teams ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Terminally Ill Patients ◽  
Hiv Management ◽  
The Social ◽  
Sub Saharan

Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent.Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered.Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data.Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes.Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.

Passionate Leaders in Social Entrepreneurship: Exploring an African Context

2015 ◽  
Vol 57 (3) ◽  
pp. 481-524 ◽  
Author(s):  
Sara Thorgren ◽  
Adesuwa Omorede
Keyword(s):  
Social Enterprise ◽  
Social Needs ◽  
Social Enterprises ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Social Mission ◽  
The Social ◽  
Sub Saharan ◽  
Private Entrepreneurs ◽  
Enterprise Leader

Nonstate actors such as social enterprises are increasingly influential for addressing pressing social needs in sub-Saharan Africa. Moving responsibility from the state to private entrepreneurs calls for a greater understanding of how single individuals achieve their social mission in a context characterized by acute poverty and where informal institutions, such as trust and collective norms, are strong governance mechanisms. This study recognizes the role of leader passion as a key element for gaining people’s trust in the social enterprise leader and the social mission. Qualitative data were collected on 37 leaders of Nigerian social enterprises in arenas such as health, women’s rights, children’s rights, AIDS/HIV care and education, and sustainable development. Drawing on 100 semistructured interviews, the authors develop an inductive model illustrating how leader passion interrelates with the social enterprise organizing and outcomes.

scholarly journals Palliative Reconstructive Surgery: Contextualizing Palliation in Resource-Poor Settings

2014 ◽  
Vol 2014 ◽  
pp. 1-10
Author(s):  
Peter M. Nthumba
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Reconstructive Surgery ◽  
Resource Constraints ◽  
Palliative Surgery ◽  
Sub Saharan Africa ◽  
Fourfold Increase ◽  
Number Of Patients ◽  
Sub Saharan

Introduction. Palliative care in Kenya and the larger Sub-Saharan Africa is considered a preserve of hospices, where these exist. Surgical training does not arm the surgeon with the skills needed to deal with the care of palliative patients. Resource constraints demand that the surgeon be multidiscipline trained so as to be able to adequately address the needs of a growing population of patients that could benefit from surgical palliation. Patients and Methods. The author describes his experience in the management of a series of 31 palliative care patients, aged 8 to 82 years. There were a total of nine known or presumed mortalities in the first year following surgery; 17 patients experienced an improved quality of life for at least 6 months after surgery. Fourteen of these were disease-free at 6 months. Conclusion. Palliative reconstructive surgery is indicated in a select number of patients. Although cure is not the primary intent of palliative surgery, the potential benefits of an improved quality of life and the possibility of cure should encourage a more proactive role for the surgeon. The need for palliative care can be expected to increase significantly in Africa, with the estimated fourfold increase of cancer patients over the next 50 years.

scholarly journals SARS-CoV-2 and HIV: Convergence of Two Pandemics in the Caribbean

2020 ◽  
Vol 3 ◽  
Author(s):  
Robert Paulino-Ramirez
Keyword(s):  
Hiv Transmission ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Caribbean Region ◽  
Community Based ◽  
Self Testing ◽  
The Social ◽  
Timely Access ◽  
The Caribbean ◽  
Sub Saharan

This article describes the social, biological, and programmatic interactions between HIV and SARS-CoV-2 co-infections in The Caribbean region. The country islands represent the second most affected region by HIV/AIDS after Sub-Saharan Africa. After the first confirmed COVID-19 cases in the region, it is necessary to reinvent the programmatic interventions designed to eliminate HIV transmission, and implement innovative interventions that are not yet currently available like PrEP, HIV self-testing, and multiple medication dispensing. COVID-19 pandemic offers an opportunity to governments, community-based organizations, and international partners to maintain the HIV care continuum, with particular efforts made to ensure timely access to, and to avoid disruption of routinely HIV services.

Comparison of Patient Self-Reported Quality of Life and Health Care Professional-Assessed Symptoms in Terminally ill Patients With Cancer

2020 ◽  
pp. 104990912094415
Author(s):  
Chikako Matsumura ◽  
Nanako Koyama ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
Takehisa Nomura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Terminally Ill ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Patient Reported ◽  
Exact Agreement

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.

scholarly journals Effectiveness of palliative care including physiotherapy in hiv patients a review of the literature

2007 ◽  
Vol 63 (2) ◽  
Author(s):  
J. Uwimana ◽  
Q Louw
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Behavioural Therapy ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Aids Epidemic ◽  
Sub Saharan ◽  
Assess Quality ◽  
Hiv Aids

It is estimated that 41 million people throughout the world are living with HIV/AIDS and of these 39 million are in sub-Saharan Africa(UNAIDS 2004).  The HIV/AIDS epidemic is devastating the African continent.In Africa poorly resourced health care infrastructure further impairs the quality of life in HIV sufferers. Palliative care is an approach that aims to improve the quality of life of people living with threatening diseases such as cancer and HIV/AIDS. This review aimed to determine the efficacy of palliative care. Complementary therapies such as Cognitive Behavioural Therapy, peer/counselling group therapy, massage  therapy, and exercise therapy constitute palliative care. Seventeen articles published in peer reviewed journals during the period 1990-2005 were reviewed. The findings of our review demonstrate that there are indications that palliative care can be effective in improving the quality of life in patients with life threatening diseases such HIV/AIDS. Research in this field is complicated by the heterogeneity of study samples, difficulty in patient recruitment, and death before the end of the intervention period. Future research in this area should aim to include larger study samples, using valid tools to assess quality of life and to employ qualitative methods in studies to assess the effectiveness of palliative care.

Is the Character of Institutional Leadership Central to the Quality of Higher Education (HE) Management?

2021 ◽  
pp. 1740-1761
Author(s):  
Nwachukwu Prince Ololube
Keyword(s):  
Higher Education ◽  
Poor Quality ◽  
Sub Saharan Africa ◽  
Institutional Leadership ◽  
Quality Of Higher Education ◽  
The Social ◽  
Sub Saharan ◽  
The Relationship

This study employed a descriptive, empirical and suggestive approach. The purpose of this study is to determine whether the character of institutional leadership is central to the management of higher education (HE). First, the study x-rayed the role of character in institutional leadership and management of HE. Second, it highlights the character of institutional leadership in combination with values, morals, principles and ethics in the management of HE, and third, the implication of the character of institutional leadership on the quality of HE. To address the descriptive part of this study, this article reviewed literature on the relationship between the character of institutional leadership with particular focus on values, morals, principles and ethics, and the quality of HE management. The empirical part of this article included the collection of data from 250 respondents through a structured questionnaire, and data were analyzed using the statistical package for the social sciences (SPSS) version 21. While the suggestive part portrayed the study's findings, which redolent that the neglect of the role of character in institutional leadership as being central to HE management might possibly explain the dysfunctional and poor quality state of HE particularly in Nigeria and perhaps many sub-Saharan Africa countries. Therefore, appointment of institutional heads should be based on technical qualification and character of institutional leaders, and must be a continual effort towards the integration of positive thoughts, both in words and in actions. The target audiences for this article include educational managers and planners, researchers, academics, professionals, students, and leadership practitioners.

scholarly journals Health-related quality of life, palliative care needs and 12-month survival among patients with end stage renal disease in Uganda: protocol for a mixed methods longitudinal study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Peace Bagasha ◽  
Mhoira Leng ◽  
Elly Katabira ◽  
Mila Petrova
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Sub Saharan Africa ◽  
Care Needs ◽  
Resource Limited ◽  
Sub Saharan ◽  
Stage Renal Disease ◽  
End Stage ◽  
Palliative Care Needs

Abstract Background The prevalence of chronic kidney disease is on the rise globally and in sub-Saharan Africa. Due to its “silent” nature, many patients often present with advanced disease. At this point options for care are often limited to renal replacement therapies such as hemodialysis and kidney transplantation. In resource limited settings, these options are associated with catastrophic expenditures and increased household poverty levels. Early palliative care interventions, if shown to ensure comparable quality of life (QoL), can significantly mitigate this by focusing care on comfort, symptom control and QoL rather than primarily on prolonging survival. Methods A mixed methods longitudinal study, recruiting patients with End Stage Renal Disease (ESRD) on hemodialysis or conservative management and following them up over 12 months. The study aims are to: 1) measure and compare the health-related quality of life (HRQoL) scores of patients with ESRD receiving hemodialysis with those receiving conservative management, 2) measure and compare the palliative care needs and outcomes of patients in the two groups, 3) explore the impact of treatment modality and demographic, socio-economic and financial factors on QoL and palliative care needs and outcomes, 4) review patient survival over 12 months and 5) explore the patients’ lived experiences. The Kidney Disease Quality Of Life Short Form version 1.3 (KDQOL-SF) will be used to measure HRQoL; the African Palliative Care Association Palliative care Outcome Score (APCA POS) and the Palliative care Outcome Score for renal symptoms (POS-S Renal) will be used to assess palliative care needs and outcomes; and semi-structured in-depth interviews to explore the patients’ experiences of living with ESRD. Data collection will be carried out at 0, 3, 6, 9 and 12 months. Discussion To the best of our knowledge, no similar study has been conducted in sub-Saharan Africa. This will be an important step towards raising awareness of patients’ need and preferences and the strengths and limitations of available health care services for ESRD in resource limited settings.

Dignity therapy, psycho-spiritual well-being and quality of life in the terminally ill: systematic review and meta-analysis

2021 ◽  
pp. bmjspcare-2021-003180
Author(s):  
Ruishuang Zheng ◽  
Qiaohong Guo ◽  
Zhiqian Chen ◽  
Yingchun Zeng
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Terminally Ill ◽  
Well Being ◽  
Cochrane Library ◽  
Anxiety And Depression ◽  
Terminally Ill Patients ◽  
Dignity Therapy ◽  
Spiritual Well Being

ObjectivesDignity therapy (DT) is a brief, individualised psychotherapy that aims to alleviate psychosocial and spiritual distress in the final stages of life. It is unknown yet whether DT can enhance sense of dignity and improve psychological and spiritual well-being as well as quality of life of terminally ill patients.MethodsWe searched PubMed, EMBASE, CINAHL plus, ProQuest Health & Medical Complete, PsycINFO and the Cochrane Library, as well as Chinese databases including Weipu Data, Wanfang Data and China National Knowledge Infrastructure from inception to 30 April 2021, for randomised controlled trials (RCTs) assessing the effects of DT on dignity, psycho-spiritual well-being and quality of life of terminally ill patients receiving palliative care.ResultsWe identified 507 unique records, and included 9 RCTs (871 participants). Comparator was standard palliative care. DT did not improve terminally ill patients’ sense of dignity (p=0.90), hope (p=0.15), spiritual well-being (p=0.99) and quality of life (p=0.23). However, DT reduced anxiety and depression after intervention (standardised mean difference, SMD=−1.13, 95% CI (−2.21 to –0.04), p=0.04; SMD=−1.22, 95% CI (−2.25 to –0.18), p=0.02, respectively) and at 4 weeks post-intervention (SMD=−0.89, 95% CI (−1.71 to –0.07), p=0.03; SMD=−1.26, 95% CI (−2.38 to –0.14), p=0.03, respectively).ConclusionDT can be offered as a psychological intervention for terminally ill patients to reduce their anxiety and depression. More studies are needed to further evaluate the effects of DT on terminally ill patients’ dignity, spiritual well-being and quality of life.

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