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Mejía Grueso A, Ramírez Pazos J, Roldán Bernal MC, López Sanmiguel A, Velásquez DA. Buen morir en la persona mayor:. UNIVERSITAS MÉDICA 2022. [DOI: 10.11144/javeriana.umed63-4.bmpm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
El buen morir es un fenómeno que se construye desde múltiples perspectivas de los actores involucrados en la atención del adulto mayor. El objetivo de este trabajo es realizar una revisión temática con análisis cualitativo del contenido 50 artículos relacionados con el buen morir en el adulto mayor publicados en los últimos 10 años. Se encontró que el buen morir carece de una definición universal y está configurada por elementos que varían según el actor involucrado, variables sociodemográficas y aspectos culturales. Visibilizar los elementos más relevantes de lo que configura el buen morir permite ampliar su comprensión, con el objetivo de mejorar la atención en el fin de vida del adulto mayor.
Palabras clave: Anciano, muerte, morir, cuidados paliativos, final de vida
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Singer S, Riccetti N, Hempler I, Fried M, Knorrenschild JR, Kalie L, Merbach M, Reiser M, Mosthaf F, Heidt V, Hermes-Moll K. Awareness and use of psychosocial care among cancer patients and their relatives-a comparison of people with and without a migration background in Germany. J Cancer Res Clin Oncol 2022; 149:1733-1745. [PMID: 35689688 PMCID: PMC9188276 DOI: 10.1007/s00432-022-04091-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022]
Abstract
Purpose We examined how migration background is associated with awareness and usage of psycho-oncology services. Methods Oncologists in community-based practices and outpatient clinics asked their patients and their relatives to complete a questionnaire. Migrants were purposely over-sampled. The questionnaire was provided in Arabic, English, Farsi, French, German, Hindi, Kurdish, Pashto, Russian, Somali, Turkish, Urdu, and Vietnamese. Results From 9 collaborators, 177 participants were enrolled (130 with and 47 without migration background). The existence of outpatient cancer counselling centres was known to 38% of the participants without and 32% with migration background, self-help groups to 32 vs. 12%, and psychotherapy to 43 vs. 25%. Respondents from the Near and Middle East were less likely to know about psychotherapy (odds ratio (OR) 0.1, p = 0.01); those from the Commonwealth of the Independent States or former Yugoslavia were less often informed about self-help groups (OR 0.1, p = 0.06). Migrants retrieved information less frequently from the internet than non-migrants (10 vs. 25%). At least one service had been used by 27% of migrants and 42% of non-migrants (OR 0.5, p = 0.06). After adjusting for gender, age, education, and patient-relative status, there was no evidence for an association between migration background and service use. Conclusions Migrants should be better informed about psychotherapy and self-help groups, in particular the ones coming from the Near or Middle East and the Commonwealth of the Independent States or former Yugoslavia. The under-use of psychosocial services can largely be explained by confounding factors. Therefore, these factors must always be taken into account when analysing the use of psychosocial services in the aforementioned populations. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-022-04091-1.
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Affiliation(s)
- Susanne Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Nicola Riccetti
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher Straße 69, 55131, Mainz, Germany
- University Cancer Centre, Mainz, Germany
| | - Isabelle Hempler
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
| | | | | | - Louma Kalie
- Institute of Pharmaceutical Sciences, Department of Pharmaceutical Technology and Biopharmacy, Albert-Ludwigs-University, Freiburg, Germany
| | - Martin Merbach
- Central Institute for Family Counselling, Berlin, Germany
- Association of Binational Families and Couples, Berlin, Germany
| | - Marcel Reiser
- Community-Based Practice for Medical Oncology, Cologne, Germany
| | - Franz Mosthaf
- Gemeinschaftspraxis für Hämatologie, Onkologie und Infektiologie, Zentrum für Ambulante Onkologie, Karlsruhe, Germany
| | - Vitali Heidt
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
| | - Kerstin Hermes-Moll
- Scientific Institute of Office-Based Haematologists and Oncologists (WINHO), Cologne, Germany
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Bhadelia A, Oldfield LE, Cruz JL, Singh R, Finkelstein EA. Identifying Core Domains to Assess the "Quality of Death": A Scoping Review. J Pain Symptom Manage 2022; 63:e365-e386. [PMID: 34896278 DOI: 10.1016/j.jpainsymman.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/18/2021] [Accepted: 11/28/2021] [Indexed: 01/13/2023]
Abstract
CONTEXT There is growing recognition of the value to patients, families, society, and health systems in providing healthcare, including end-of-life care, that is consistent with both patient preferences and clinical guidelines. OBJECTIVES Identify the core domains and subdomains that can be used to evaluate the performance of end-of-life care within and across health systems. METHODS PubMed/MEDLINE (NCBI), PsycINFO (ProQuest), and CINAHL (EBSCO) databases were searched for peer-reviewed journal articles published prior to February 22, 2020. The SPIDER tool was used to determine search terms. A priori criteria were followed with independent review to identify relevant articles. RESULTS A total of 309 eligible articles were identified out of 2728 discrete results. The articles represent perspectives from the broader health system (11), patients (70), family and informal caregivers (65), healthcare professionals (43), multiple viewpoints (110), and others (10). The most common condition of focus was cancer (103) and the majority (245) of the studies concentrated on high-income country contexts. The review identified five domains and 11 subdomains focused on structural factors relevant to end-of-life care at the broader health system level, and two domains and 22 subdomains focused on experiential aspects of end-of-life care from the patient and family perspectives. The structural health system domains were: 1) stewardship and governance, 2) resource generation, 3) financing and financial protection, 4) service provision, and 5) access to care. The experiential domains were: 1) quality of care, and 2) quality of communication. CONCLUSION The review affirms the need for a people-centered approach to managing the delicate process and period of accepting and preparing for the end of life. The identified structural and experiential factors pertinent to the "quality of death" will prove invaluable for future efforts aimed to quantify health system performance in the end-of-life period.
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Affiliation(s)
- Afsan Bhadelia
- Department of Global Health and Population (A.B.), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| | | | - Jennifer L Cruz
- Department of Social and Behavioral Sciences (J.L.C.), Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ratna Singh
- Lien Centre for Palliative Care (R.S., E.A.F.), Duke-NUS Medical School, Singapore, Singapore
| | - Eric A Finkelstein
- Lien Centre for Palliative Care (R.S., E.A.F.), Duke-NUS Medical School, Singapore, Singapore
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The perspective of professional caregivers working in generalist palliative care on 'good dying': An integrative review. Soc Sci Med 2021; 293:114647. [PMID: 34902648 DOI: 10.1016/j.socscimed.2021.114647] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022]
Abstract
In today's industrial societies, many people die receiving professional care. Although specialist palliative and hospice care have often been identified as ideal care approaches to promote good dying, more people die receiving generalist palliative care. This integrative review examines how professional caregivers providing generalist palliative care in hospitals, nursing or private homes define good dying. Furthermore, through comparative analysis of existing empirical studies, it explores conceptual aspects in researching good dying that better reflect the social complexity of this phenomenon. Three databases (Scopus, MEDLINE, and CINAHL) were searched for peer-reviewed studies published between January 2000 and April 2020. Studies were selected if they presented original empirical findings from qualitative or quantitative studies on the perspective of professional caregivers in generalist palliative care (nurses, physicians, surgeons, clergy, and other staff) on good dying or related concepts (e.g., good death, dignity in dying, or quality of life at the end of life). 42 studies were included in the review. They identified good dying as expected, accepted and prepared dying, as free from pain and suffering, as socially embedded, as being at peace with one's life and situation, as supported with individualised and holistic care, as based upon professional cooperation and communication, and as in a peaceful and private environment. The paper concludes that the perspective of professional caregivers in generalist palliative care shares many elements of good dying with societal and specialist palliative care discourses around good dying. Through comparing the different studies, the review found that studies that explicated who benefitted from ideals and practices of good dying, questioned the dichotomous categorisation of good/bad dying, or discussed the compatibility of elements of good dying, provided more nuanced perspectives on this topic. Thus, the review calls for a more systematic analysis of these aspects in research of good dying.
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Daniels-Howell C. Caring for Children With Life-Limiting Illness in Bloemfontein, South Africa: Challenging the Assumptions of the 'Good Death'. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:317-344. [PMID: 32703072 DOI: 10.1177/0030222820944099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Theories of good death focused on acceptance, control, and meaning-making inform adult palliative care in high-resource settings. As children's palliative and hospice care (CPHC) develops in resource-limited settings, critical conceptualisations of a good death for children across these diverse settings are unknown. Assessed against high-resource setting tenets of good death from carer perspectives, results suggest: carer agency is limited; advanced discussion of death does not occur; distress results from multiple burdens; basic survival is prioritised; physical pain is not an emphasised experience; and carers publicly accept death quickly while private grief continues. Hegemonic conceptions of 'good death' for children do not occur in contexts where agency is constrained and discussing death is taboo, limiting open discussion, acceptance, and control of dying experiences. Alternate forms of discourse and good death could still occur. Critical, grounded conceptualisations of good death in individual resource-limited settings should occur in advance of CPHC development to effectively relieve expansive suffering in these contexts.
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Fearon D, Kane H, Aliou N, Sall A. Perceptions of palliative care in a lower middle-income Muslim country: A qualitative study of health care professionals, bereaved families and communities. Palliat Med 2019; 33:241-249. [PMID: 30554550 PMCID: PMC6350179 DOI: 10.1177/0269216318816275] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: Palliative care has been successfully integrated into many Muslim-majority countries, most frequently in urbanised areas with developed health care systems. Less is known as to how the concept of palliative care is perceived by Muslim populations and health workers in rural, resource-limited contexts. AIM: This study seeks to explore whether the principles of palliative care are congruent with the perspectives of health professionals, families and communities in rural areas of the Islamic Republic of Mauritania, in West Africa. DESIGN: A qualitative research design was employed underpinned by a constructionist paradigm. Data were collected through 31 interviews and 8 focus groups. Data were analysed using thematic analysis. SETTING/PARTICIPANTS: A total of 76 participants were recruited from across rural Mauritania; 33 health care professionals, 12 recently bereaved family members and 31 community leaders. Data collection occurred during training events in the capital and visits to villages and rural health posts. RESULTS: Three major themes were identified. First, there is a perceived lack of congruency between an illness which limits life and the strong belief in destiny. The second theme describes the perceived barriers to communication of issues relating to palliative care. Finally, a good death is described, framed within the interplay of religious faith and cultural practices. CONCLUSION: The palliative care ethos is viewed positively by the majority of participants. The need to understand and respect a Muslim individual’s faith does not diminish our obligation to personalise palliative care provided for them and their family.
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Affiliation(s)
- David Fearon
- 1 Cairdeas International Palliative Care Trust, Nouakchott, Mauritania
| | - Hélène Kane
- 2 Unité Mixte Internationale Environnement Santé Sociétés, Dakar, Senegal
| | - N'Diaye Aliou
- 3 Action Sahara pour la Santé, l'Innovation, le Développement et l'Education, Nouakchott, Mauritania
| | - Alhousseynou Sall
- 3 Action Sahara pour la Santé, l'Innovation, le Développement et l'Education, Nouakchott, Mauritania
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Block E. Living, dying, after death: Achieving a "good" death in the time of AIDS orphan care. DEATH STUDIES 2018; 42:275-281. [PMID: 29173120 DOI: 10.1080/07481187.2017.1396396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIDS has devastated communities across southern Africa, leaving many children orphaned. Grandmothers are considered ideal caregivers because of cultural expectations of intergenerational care, and because they have not been decimated by AIDS to the same extent as younger adults. However, these grandmothers, who currently carry the majority of the burden of care for AIDS orphans, are themselves aging and dying. I argue here that in Lesotho, the caregiving demanded of grandmothers late into their lives not only alters kin relations for the living but has increasingly made a "good" death unachievable for elderly caregivers.
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Affiliation(s)
- Ellen Block
- a College of St. Benedict & St. John's University , Collegeville , Minnesota , USA
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"We never speak about death." Healthcare professionals' views on palliative care for inpatients in Tanzania: A qualitative study. Palliat Support Care 2017; 16:566-579. [PMID: 28829011 DOI: 10.1017/s1478951517000748] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:Little is known about the current views and practices of healthcare professionals (HCPs) in Sub-Saharan Africa (SSA) regarding delivery of hospital palliative care. The present qualitative study explored the views of nursing staff and medical professionals on providing palliative and end-of-life care (EoLC) to hospital inpatients in Tanzania. METHOD Focus group discussions were conducted with a purposive sample of HCPs working on the medical and pediatric wards of the Kilimanjaro Christian Medical Centre, a tertiary referral hospital in northern Tanzania. Transcriptions were coded using a thematic approach. RESULTS In total, 32 healthcare workers were interviewed via 7 focus group discussions and 1 semistructured interview. Four major themes were identified. First, HCPs held strong views on what factors were important to enable individuals with a life-limiting diagnosis to live and die well. Arriving at a state of "acceptance" was the ultimate goal; however, they acknowledged that they often fell short of achieving this for inpatients. Thus, the second theme involved identifying the "barriers" to delivering palliative care in hospital. Another important factor identified was difficulty with complex communications, particularly "breaking bad news," the third theme. Fourth, participants were divided about their personal preferences for "place of EoLC," but all emphasized the benefits of the hospital setting so as to enable better symptom control. SIGNIFICANCE OF RESULTS Despite the fact that all the HCPs interviewed were regularly involved in providing palliative and EoLC, they had received limited formal training in its provision, although they identified such training as a universal requirement. This training gap is likely to be present across much of SSA. Palliative care training, particularly in terms of communication skills, should be comprehensively integrated within undergraduate and postgraduate education. Research is needed to develop culturally appropriate curricula to equip HCPs to manage the complex communication challenges that occur in caring for a diverse inpatient group with palliative care needs.
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Mumm R, Diaz-Monsalve S, Hänselmann E, Freund J, Wirsching M, Gärtner J, Gminski R, Vögtlin K, Körner M, Zirn L, Wittwer-Backofen U, Oni T, Kroeger A. Exploring urban health in Cape Town, South Africa: an interdisciplinary analysis of secondary data. Pathog Glob Health 2017; 111:7-22. [PMID: 28093045 DOI: 10.1080/20477724.2016.1275463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND With modern information technology, an overwhelming amount of data is available on different aspects of societies. Our research investigated the feasibility of using secondary data sources to get an overview of determinants of health and health outcomes in different population strata of Cape Town, a large city of South Africa. METHODS The methodological approach of secondary-data analysis was similar in the different disciplines: Biological Anthropology, Public Health, Environmental Health, Mental Health, Palliative Care, Medical Psychology and Sociology at the University of Freiburg and Public Health at the University of Cape Town. The teams collected information on Cape Town through Internet searches and published articles. The information was extracted, analyzed, condensed, and jointly interpreted. RESULTS Data show the typical picture of a population in epidemiological and demographic transition exposed to often difficult social, mental, and physical environmental conditions. Comparison between low and higher socioeconomic districts demonstrated that the former had higher air pollution, poorer water quality, and deficient sanitary conditions in addition to sub-optimal mental health services and palliative care. CONCLUSION Although important information gaps were identified, the data draw attention to critical public health interventions required in poor health districts, and to motivate for pro-equity policies.
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Affiliation(s)
- Rebekka Mumm
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,b Faculty of Medicine, Biological Anthropology , University of Freiburg , Freiburg , Germany
| | - Sonia Diaz-Monsalve
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany
| | - Eva Hänselmann
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,c Faculty of Medicine, Clinic for Psychosomatic Medicine und Psychotherapy , University of Freiburg , Freiburg , Germany
| | - Johanna Freund
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,c Faculty of Medicine, Clinic for Psychosomatic Medicine und Psychotherapy , University of Freiburg , Freiburg , Germany
| | - Michael Wirsching
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,c Faculty of Medicine, Clinic for Psychosomatic Medicine und Psychotherapy , University of Freiburg , Freiburg , Germany
| | - Jan Gärtner
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,d Faculty of Medicine, Clinic for Palliative Care , University of Freiburg , Freiburg , Germany
| | - Richard Gminski
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,e Faculty of Medicine, Institute of Environmental Medicine and Hospital Hygiene , University of Freiburg , Freiburg , Germany
| | - Katrin Vögtlin
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,e Faculty of Medicine, Institute of Environmental Medicine and Hospital Hygiene , University of Freiburg , Freiburg , Germany
| | - Mirjam Körner
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,f Faculty of Medicine, Medical Sociology and Psychology , University of Freiburg , Freiburg , Germany
| | - Lena Zirn
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,f Faculty of Medicine, Medical Sociology and Psychology , University of Freiburg , Freiburg , Germany
| | - Ursula Wittwer-Backofen
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany.,b Faculty of Medicine, Biological Anthropology , University of Freiburg , Freiburg , Germany
| | - Tolu Oni
- g Division of Public Health Medicine, School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Axel Kroeger
- a Center for Medicine and Society , University of Freiburg , Freiburg , Germany
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Fang ML, Sixsmith J, Sinclair S, Horst G. A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review. BMC Geriatr 2016; 16:107. [PMID: 27193395 PMCID: PMC4872365 DOI: 10.1186/s12877-016-0282-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 05/11/2016] [Indexed: 11/23/2022] Open
Abstract
Background Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. Methods To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June–August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004–2014. Results The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making. Conclusions This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0282-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mei Lan Fang
- Gerontology Research Centre, Simon Fraser University, 2800-515 West Hastings Street, Vancouver, BC, V6B 5 K3, Canada.
| | - Judith Sixsmith
- Institute of Health and Wellbeing, University of Northampton, Northampton, UK.,School of Public Policy, Simon Fraser University, Vancouver, BC, Canada
| | - Shane Sinclair
- Faculty of Nursing, University of Calgary, Calgary, AB, Canada.,Hospice Clinical Team, Canadian Virtual Hospice, Winnipeg, MB, Canada
| | - Glen Horst
- Hospice Clinical Team, Canadian Virtual Hospice, Winnipeg, MB, Canada
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Appelbaum Belisle H, Hennink M, Ordóñez CE, John S, Ngubane-Joye E, Hampton J, Sunpath H, Preston-Whyte E, Marconi VC. Concurrent use of traditional medicine and ART: Perspectives of patients, providers and traditional healers in Durban, South Africa. Glob Public Health 2014; 10:71-87. [PMID: 25346069 DOI: 10.1080/17441692.2014.967709] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The concurrent use of traditional African medicine (TAM) and allopathic medicine is not well understood for people living with HIV (PLHIV) in the era of antiretroviral therapy (ART). This cross-sectional, qualitative study examines perceptions of the concurrent use of TAM and ART among: (1) patients receiving ART at the Sinikithemba HIV Clinic of McCord Hospital, in Durban, South Africa; (2) allopathic medical providers (doctors, nurses and HIV counsellors) from Sinikithemba; and (3) local traditional healers. Data were collected through in-depth interviews and focus group discussions with 26 participants between July and October, 2011. Patients in this study did not view TAM as an alternative to ART; rather, results show that patients employ TAM and ART for distinctly different needs. More research is needed to further understand the relationship between traditional and allopathic approaches to health care in South Africa, to improve cultural relevance in the provision and delivery of care for PLHIV, and to pragmatically address the concerns of health care providers and public health officials managing this intersection in South Africa and elsewhere.
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Affiliation(s)
- Hannah Appelbaum Belisle
- a Hubert Department of Global Health, Rollins School of Public Health , Emory University , Atlanta , GA , USA
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Stanford J, Sandberg DM, Gwyther L, Harding R. Conversations Worth Having: The Perceived Relevance of Advance Care Planning among Teachers, Hospice Staff, and Pastors in Knysna, South Africa. J Palliat Med 2013; 16:762-7. [DOI: 10.1089/jpm.2013.0051] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Dale M. Sandberg
- Knysna Sedgefield Hospice, Knysna, South Africa
- Department of Social Policy, London School of Economics, London, United Kingdom
| | - Liz Gwyther
- Palliative Medicine Programme, Department of Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Richard Harding
- Palliative Medicine Programme, Department of Family Medicine, University of Cape Town, Cape Town, South Africa
- Department of Palliative Care, Cicely Saunders Institute, King's College London, London, United Kingdom
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