Digital Commons Network^™

Research Attitudes, Practice And Literacy Among Kenyan Palliative Care Healthcare Professionals: An Observational, Crosssectional Online Survey, Ra Powell, Z Ali, Nancy Gikaara, Qanungo S, Es Melikam, Kb Cartmell

Internal Medicine, East Africa

Background: While research is needed to advocate for implementation of global agendas to strengthen palliative care, healthcare professionals’ research literacy must improve to bridge the gap between evidence and practice. A resurgent focus on North-South power disparities, means attention should also focus on understanding low- and middle-income countries’ local agency to implement palliative care research agendas.

Methods: An observational, cross-sectional online survey among Kenyan palliative healthcare professionals currently working at any of the palliative and hospice care organizations operational during January – December 2019, using descriptive statistics.

Results: Among the 93 survey respondents, participants were mainly nurses (50.54%; n=47). Regarding …

Essential Package Of Palliative Care For Women With Cervical Cancer: Responding To The Suffering Of A Highly Vulnerable Population, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa

Department of Anaesthesia

Women with cervical cancer, especially those with advanced disease, appear to experience suffering that is more prevalent, complex, and severe than that caused by other cancers and serious illnesses, and approximately 85% live in low- and middle-income countries where palliative care is rarely accessible. To respond to the highly prevalent and extreme suffering in this vulnerable population, we convened a group of experienced experts in all aspects of care for women with cervical cancer, and from countries of all income levels, to create an essential package of palliative care for cervical cancer (EPPCCC). The EPPCCC consists of a set of …

Augmented Package Of Palliative Care For Women With Cervical Cancer: Responding To Refractory Suffering, Eric L. Krakauer, Khadidjatou Kane, Xiaoxiao Kwete, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Lawrence F. Borges, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa

Department of Anaesthesia

The essential package of palliative care for cervical cancer (EPPCCC), described elsewhere, is designed to be safe and effective for preventing and relieving most suffering associated with cervical cancer and universally accessible. However, it appears that women with cervical cancer, more frequently than patients with other cancers, experience various types of suffering that are refractory to basic palliative care such as what can be provided with the EPPCCC. In particular, relief of refractory pain, vomiting because of bowel obstruction, bleeding, and psychosocial suffering may require additional expertise, medicines, or equipment. Therefore, we convened a group of experienced experts in all …

Cervical Cancer-Associated Suffering: Estimating The Palliative Care Needs Of A Highly Vulnerable Population, Eric L. Krakauer, Xiaoxiao Kwete, Khadidjatou Kane, Gauhar Afshan, Lisa Bazzett-Matabele, Danta Dona Ruthnie Bien-Aimé, Sarah Byrne-Martelli, Stephen Connor, Raimundo Correa, C R Beena Devi C R Beena Devi

Department of Anaesthesia

Purpose: To enable design of optimum palliative care for women with cervical cancer, we studied the most common types of suffering and their severity, prevalence, and duration.
Methods: We first reviewed the literature on the major types, severity, prevalence, and duration of suffering associated with cervical cancer. We then conducted a modified Delphi process with experts in cervical cancer care to supplement the literature. For each type of suffering, we distinguished between decedents (those who die from cervical cancer in a given year) and nondecedents (those who have cervical cancer in a given year but do not die). By applying …

Assessment Of Palliative Care Needs In A Kenyan Intensive Care Unit Based On A Trigger-Based Model., Linda Atero Barasa

Master of Medicine in Internal Medicine

Background: Palliative care triggers have been used in the Intensive Care Unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. Objectives: The primary objective of this study was to estimate the prevalence of ICU admissions who meet the criteria for one or more palliative care triggers. The secondary objectives were to determine an association between palliative care consults and length of ICU stay, mortality, and time to formal change of goals of care …

Multidisciplinary Care In Motor Neuron Disease, Sara Khan

Pakistan Journal of Neurological Sciences (PJNS)

Motor neuron disease (MND) is a progressive degenerative disorder of the motor neurons, resulting in progressive limb, bulbar and respiratory muscle weakness. No definitive disease modifying treatment is available at this time. The mainstay of management remains multidisciplinary care, which has shown to improve quality of life, prevents complications and may also increase life span. In this review, different medical specialties necessary to offer complete multidisciplinary care are discussed. Symptomatic management of individual symptoms commonly experienced by patients with MND is elaborated on.

Mhealth In Palliative Care For Cancer Patients & Care Givers, Newton Andebe, Peter Waiganjo, John Weru

Internal Medicine, East Africa

Patients and caregivers in palliative care experience multidimensional pain. In current practice, information about a cancer patient progress is known when they visit a clinic or make a distress call when their conditions worsen. This strategy is not efficient for systematic monitoring of symptoms, which is key in improving palliative care. Mobile phones have helped to transform healthcare through diagnosis, health education and symptoms management of chronic illnesses. In this study, a mobile phone assessment tool was implemented at an outpatient palliative care clinic for cancer patients in Aga Khan University Hospital, Nairobi. The usefulness of the mobile phone application …

Factors That Influence Advance Directives Completion Amongst Terminally Ill Patients At Akuhn, Stephen Omondi Otieno

Master of Medicine in Internal Medicine

Background: An advance directive is a written or verbal document that legally stipulates a person’s health care preference while they are competent to make decisions for themselves, and which is then used to guide decisions on life-sustaining treatment in the event that they become incapacitated. Advance directives can take one of four forms: a living will, a limitation of care document, a do-not-resuscitate order, and an appointment of a surrogate by durable power of attorney. The completion rate of advance directives varies from region to region, and it is influenced by different patient, caregiver, legal, institutional, cultural, and religious factors. …

Palliative Care For People Living With Hiv/Aids In Uganda: An Investigation Of Patients & Caregiver’S Outcome And Professional Perspectives, Wesley Too

School of Nursing & Midwifery, East Africa

Background: Although antiretroviral treatment is expanding in sub-Saharan Africa, the World Health Organization advocates for integration of palliative care with HAART because pain, other distressing symptoms and complex psychosocial challenges persist throughout the HIV trajectory. Palliative care improves the outcome for patients with HIV and may complement antiretroviral treatment by increasing adherence through better management of side effects from the treatment, providing patient and family-centred holistic care, and giving end-of-life care when necessary. However, integrating what have become two disciplines is challenging. Aim: To study the implications for palliative care provision in the context of changing policy to universal access …