Palliative care skills training needed for health-care staff in sub-Saharan Africa

Apr 22, 2009

A new study, led by Lucy Selman and colleagues from King's College London, has found that patients with incurable, progressive diseases and their family carers in sub-Saharan Africa often do not receive enough information about the patient's disease and its management, which impacts negatively on their ability to cope with illness. The results of the study have been published online by the BMJ today.

The study was conducted in collaboration with five services in South Africa and Uganda and the palliative care associations of South Africa (HPCA) and Africa (APCA).

A major finding from interviews with 90 and 38 family carers was that healthcare staff did not provide enough information to help patients and carers understand the disease, its causes and symptoms, as well as its treatment and management. Patients and carers also felt insufficiently informed about the financial and social support available to them. These information gaps can cause anxiety for the patient and affect the family's ability to provide good patient care.

Patients and carers drew on a wide range of sources for information, including friends and family, peers with a similar condition and the media. Although patients and carers appreciated efforts made by their palliative care team to provide information, many still had unanswered questions.

For example, a patient with HIV reported that hospital staff never properly explained his diagnosis, likely symptoms and future care. Other patients talked about not receiving the results of blood tests, and described the trauma of being broken bad news in an insensitive manner. Carers reported not being told the patient's diagnosis directly, but learning it from his or her medical notes or from simply being sent on an HIV education course.

'The poor knowledge and lack of information provided impacted negatively on patients' and carers' ability to cope with their situation. For both groups, not having the information they needed was related to anxiety regarding the disease and the future', said Lucy Selman, Research Associate in the Department of Palliative Care, Policy & Rehabilitation at King's.

'The study highlights that it is crucial for all clinical staff to receive generalist training in palliative care skills, including communication and basic counselling. Communication with patients and carers should be open and honest, and records be kept of the discussions between healthcare staff and patients regarding their condition. It is also essential that services work closely with families and volunteer carers in the community, empowering them to provide the care the patient needs, including sensitive and accurate communication.'

This study is the first to explore the information needs of patients and carers attending palliative care services in Africa, identify information needs and understand past experiences of communicating with healthcare staff. Patients' diagnoses included cancer (28 cases), HIV infection (61) and motor neurone disease (1).

More information: The full paper can be obtained on the BMJ website: www.bmj.com/cgi/content/full/338/apr22_1/b1326

Source: King's College London (news : web)

Explore further: Key element of CPR missing from guidelines

add to favorites email to friend print save as pdf

Related Stories

Beyond the terminal: Palliative care

Apr 15, 2008

Palliative care was once reserved for patients when all curative options had been exhausted and death was imminent, but now it is considered an integral part of the care that should be available to patients with serious respiratory ...

Young women warned of lung cancer risks

Apr 03, 2009

Seventeen people are still dying from lung cancer each week in Northern Ireland despite a small improvement in survival rates for the disease.

Recommended for you

Exploring 3-D printing to make organs for transplants

3 hours ago

Printing whole new organs for transplants sounds like something out of a sci-fi movie, but the real-life budding technology could one day make actual kidneys, livers, hearts and other organs for patients ...

High frequency of potential entrapment gaps in hospital beds

5 hours ago

A survey of beds within a large teaching hospital in Ireland has shown than many of them did not comply with dimensional standards put in place to minimise the risk of entrapment. The report, published online in the journal ...

Key element of CPR missing from guidelines

Jul 29, 2014

Removing the head tilt/chin lift component of rescue breaths from the latest cardiopulmonary resuscitation (CPR) guidelines could be a mistake, according to Queen's University professor Anthony Ho.

Burnout impacts transplant surgeons (w/ Video)

Jul 28, 2014

Despite saving thousands of lives yearly, nearly half of organ transplant surgeons report a low sense of personal accomplishment and 40% feel emotionally exhausted, according to a new national study on transplant surgeon ...

User comments : 0