• J Pain Symptom Manage · Dec 2022

    "From the time you start with them until the Lord calls you": A qualitative study on the experiences and expectations of people living with advanced cancer interacting with palliative care services in Uganda, Nigeria and Zimbabwe.

    • Elizabeth Namukwaya, Elizabeth Nabirye, Adlight Dandadzi, David Akeju, Samuel Adejoh, Eve Namisango, Kennedy Nkhoma, Bassey Ebenso, and Matthew J Allsop.
    • Department of Internal Medicine, Makerere University, Kampala, Uganda.
    • J Pain Symptom Manage. 2022 Dec 1; 64 (6): 588601588-601.

    ContextA challenge facing the provision of palliative care in sub-Saharan Africa is a means of increasing coverage of services whilst maintaining quality. Developing an evidence base that reflects patients' experiences and expectations of palliative care services, the context within which services are provided, and the approaches adopted by services in caring for patients, could facilitate and inform the planning and development of patient-centered and responsive services.ObjectivesTo explore the experiences and expectations of palliative care for people living with advanced cancer in Nigeria, Uganda, and Zimbabwe.MethodsA secondary qualitative analysis of in-depth interviews with 62 people with advanced cancer in Nigeria, Uganda, and Zimbabwe. Framework approach to thematic analysis of transcripts was adopted, focusing on patients' experiences and expectations when interacting with palliative care services, aligning reporting with the COnsolidated criteria for REporting Qualitative research (COREQ).ResultsFour main themes were generated from the analysis: 1) Condition and community as drivers of a multidimensional burden when living with advanced cancer; 2) The expectations and endeavors of palliative care to ameliorate the impact of cancer on physical, psychological and basic needs; 3) Processes and preferences for interacting and communicating with palliative care services, and; 4) Restoration of hope in the context of limited resources.ConclusionWide-ranging physical, psychological, social and financial impacts on participants were outlined. These concerns were largely met with compassionate and responsive care in the context of constrained resources. Study findings can inform evolving notions of patient-centred care for serious illnesses in the participating countries.Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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