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Lin CY, Meagher K, Bricknell M, Patel P, El Achi N, Kutluk T, Harding R, Kienzler H, Giacaman R, Mukherji D, Shamieh O, Sullivan R. The challenges of international collaboration in conflict and health research: experience from the Research for Health in Conflict-Middle East and North Africa (R4HC-MENA) partnership. Confl Health 2023; 17:29. [PMID: 37316903 DOI: 10.1186/s13031-023-00527-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Healthcare is a basic human right extending across all humanitarian contexts, including conflict. Globally, two billion people are living under conditions of insecurity and violent armed conflict with a consequent impact on public health. Health research in conflict-affected regions has been recognised as important to gain more understanding of the actual needs of such populations, to optimise healthcare delivery, as well as to inform advocacy and policy change. International collaborative research maximises the resources and skills available for dealing with global health issues, builds capacity and endeavours to ensure the research reflects real needs of the populations. Under the UK's Global Challenge Research Fund in 2017 a number of such international programs were created including the Research for Health in Conflict-Middle East and North Africa (R4HC-MENA) partnership to build capacity in conflict and health research as well as study specific areas, namely noncommunicable diseases in conflict (cancer & mental health) and the political economy of health in conflict. METHODS A qualitative study using semi-structured online interviews was conducted to explore researchers' and stakeholders' perspectives on the R4HC-MENA programme over its lifetime from 2017 to 2021. It aimed to understand the factors that influenced and accelerated international collaboration within the R4HC-MENA programme on conflict and health research, and to provide deeper insights into the implementation of the programme. Data collection was conducted from March 2022 to June 2022. Purposive and snowball sampling techniques were used for participant recruitment. Thematic analysis was applied for data analysis. RESULTS Twelve researchers/stakeholders participated in this study: four men and eight women. Four main themes were generated: Theme 1: Network building (personal and institutional levels); Theme 2: Hierarchies and power dynamics (power imbalance between different academic status, genders and institutions); Theme 3: Communication challenges; Theme 4: Career development (management, leadership, research, and teaching skills). CONCLUSIONS This study provided preliminary insights into perspectives on international collaboration in a major international programme of research on conflict and health. Several key challenges and outputs were generated by the researchers in this study. The findings are important for further developing effective strategies to tackle the challenge of power imbalance and ineffective communication in international research collaborations.
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Affiliation(s)
- Chiu-Yi Lin
- Centre for Conflict and Health Research, King's College London, London, UK.
| | - Kristen Meagher
- Centre for Conflict and Health Research, King's College London, London, UK
| | - Martin Bricknell
- Centre for Conflict and Health Research, King's College London, London, UK
| | - Preeti Patel
- Centre for Conflict and Health Research, King's College London, London, UK
| | - Nassim El Achi
- Centre for Conflict and Health Research, King's College London, London, UK
| | - Tezer Kutluk
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Richard Harding
- Florence Nightingale Faculty of Nursing Midwifery & Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Hanna Kienzler
- Department of Global Health & Social Medicine, School of Global Affairs, King's College London, London, UK
| | - Rita Giacaman
- Institute of Community and Public Health, Birzeit University, West Bank, Birzeit, Occupied Palestinian Territory
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict, King Hussein Cancer Center, Amman, Jordan
| | - Richard Sullivan
- Centre for Conflict and Health Research, King's College London, London, UK
- King's Institute Cancer Policy, King's College London, London, UK
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Pumphrey I, Serventi F, Kahakwa A, Massawe A, Henke AA, Henke O. Impact of COVID-19 on delivery of oncology services in Northern Tanzania: a cross-sectional study of community health workers and patients undergoing cancer treatment at the Kilimanjaro Christian Medical Centre. BMJ Open 2023; 13:e069142. [PMID: 37080627 PMCID: PMC10123862 DOI: 10.1136/bmjopen-2022-069142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVE To ascertain how the COVID-19 pandemic was perceived by oncology patients and community health workers (CHWs) and whether this contributed to disruptions in cancer care. DESIGN Cross-sectional study using (1) structured telephone interviews with patients and (2) structured questionnaires completed by CHWs. SETTING Outpatient and community care at Kilimanjaro Christian Medical Centre's Cancer Care Centre (KCMCCCC), Northern Tanzania. PARTICIPANTS 300 oncology patients (158 men and 142 women) who had attended KCMCCCC between January and April 2020 and 78 CHWs (16 men and 62 women) in the KCMC regional palliative care network who conducted home visits to patients with cancer during the period January to April 2020. PRIMARY OUTCOME MEASURES For patients, missed appointments and fear of COVID-19 more than postponement of their treatment. For CHWs, no primary outcome (a broad range of questions on perception of the pandemic were asked). RESULTS 30% of patients said they missed appointments due to the pandemic, the most commonly cited reasons being financial problems (37%) and fear of acquiring COVID-19 infection during travel and/or in the hospital (37%). Only 12.7% of patients said they feared COVID-19 more than postponement of cancer treatment. 88% of CHWs noticed differences in delivering home care since the start of the pandemic, with 58% saying they had noticed more patients dying and 74% saying that more patients were relying on local healers. 31% of CHWs said they feared home visits because of COVID-19 and 46% perceived patients feared home visits due to COVID-19. However, 92% felt home visits should continue. CONCLUSION These results indicated that while there was a significant degree of disruption and fear around the COVID-19 pandemic, the majority of patients and CHWs did not fear of COVID-19 more than disruption to cancer care. This highlights the importance to these groups of maintaining access to vital cancer services.
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Affiliation(s)
- India Pumphrey
- Institute for Tropical Medicine and Public Health, Charite-Universitatsmedizin Berlin, Berlin, Germany
| | - Furaha Serventi
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Atukuzwe Kahakwa
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Anna Massawe
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Antje Annaliese Henke
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Institute for Medical Epidemiology, Biostatistics and Informatics, Center of Health Sciences, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Oliver Henke
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
- Institute for Hygiene and Public Health, Section Global Health, University of Bonn, Bonn, Germany
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Downing J, Namisango E, Connor S, Batanda P, Irumba LC, Basemera B, Jatho A, Nakami S, Nalubega H, Kamate A, Basirika D, Zalwango J, Namuddu M, Chiyoka W, Kayondo F, Byaruhanga D, Rusanganwa E, Davis H, Watiti S, Gaolebale B, Ahern LN, Thomas L, Luyirika E. The Declaration on Palliative Care in a Pandemic: report of the African Ministers of Health Meeting and the 7th International African Palliative Care Conference, held from the 24th to 26th August 2022 in Kampala, Uganda and virtually. Ecancermedicalscience 2022; 16:1474. [PMID: 36819822 PMCID: PMC9934884 DOI: 10.3332/ecancer.2022.1474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Indexed: 11/24/2022] Open
Abstract
The 7th International African Palliative Care Conference and the 4th African Ministers of Health Meeting were held in Kampala from the 24th to 26th August 2022. The theme of the conference - Palliative Care in a Pandemic - reflected the reality of palliative care provision on the continent, and the experience of patients and providers over the past 2 years. It was hosted by the African Palliative Care Association and the Worldwide Hospice Palliative Care Alliance with co-sponsors being the International Children's Palliative Care Network, the International Association of Hospice and Palliative Care, Global Partners in Care and Palliative care in Humanitarian Aid Situations and Emergencies. The conference was held in Kampala as a hybrid event, with a mix of in-person, pre-recorded and virtual presentations. The African Ministers of Health Meeting held on the 24th August was attended by delegates from 25 Ministries of Health, with 92 participants in-person and 122 attending virtually. Hosted by the Minister of State for Primary Health Care in Uganda, the participants at the meeting endorsed a Declaration on Palliative Care in a Pandemic. The main conference, held on the 25th and 26th August, was attended by 334 delegates from 40 countries, 199 (60%) of whom attended in-person. Key themes discussed throughout the conference included: contagious compassion; building a business case and evidence for palliative care in Africa; palliative care policy, funding and sustainability; the importance of collaboration and global partnerships; palliative care for all ages, children through to the elderly, and all conditions; the need to be innovative and creative, embracing technology; and a feeling of hopefulness in the future of palliative care in the region as we go forward together. The impact of the pandemic has been significant on everyone. Despite this, and the limitations imposed by the pandemic, the African palliative care community has come through it stronger, is committed to continuing the development of palliative care across the region, working together and is hopeful for the future.
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Affiliation(s)
- Julia Downing
- Makerere/Mulago Palliative Care Unit, Kampala, Uganda,International Children’s Palliative Care Network, Durban 3624, South Africa,African Palliative Care Association UK, London DA7 6AZ, UK
| | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
| | - Stephen Connor
- Worldwide Hospice Palliative Care Alliance, London WC1X 9JG, UK
| | | | | | | | | | | | | | | | | | | | - Mable Namuddu
- African Palliative Care Association, Kampala, Uganda
| | | | | | | | | | - Helena Davis
- Worldwide Hospice Palliative Care Alliance, London WC1X 9JG, UK
| | - Stephen Watiti
- Worldwide Hospice Palliative Care Alliance, London WC1X 9JG, UK
| | - Babe Gaolebale
- Worldwide Hospice Palliative Care Alliance, London WC1X 9JG, UK
| | - Lacey N Ahern
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN 46556, USA,Hospice Foundation/Global Partners in Care, Mishawaka, IN 46545, USA
| | - Lydia Thomas
- Hospice Foundation/Global Partners in Care, Mishawaka, IN 46545, USA
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Downing J, Niyonzima N, Mwebesa E, Mutyaba I, Ddungu H, Irumba LC, Zirimenya L, Basirika D, Mbarusha I, Kobusingye C, Happy M, Jatho A, Adong DO, Kabagambe C, Mpamani C, Nalukwago Z, Kyomuhangi Z, Zalwango J, Orem J, Mwesiga M. Cancer and palliative care in COVID-19 and other challenging situations-highlights from the Uganda Cancer Institute-Palliative Care Association of Uganda 3rd Uganda Conference on Cancer and Palliative Care, 23-24 September 2021, held in Kampala, Uganda and virtually. Ecancermedicalscience 2022; 15:1333. [PMID: 35211202 PMCID: PMC8816507 DOI: 10.3332/ecancer.2021.1333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Indexed: 11/06/2022] Open
Abstract
The 3rd Uganda Conference on Cancer and Palliative Care was held in September 2021 with the theme: cancer and palliative care in COVID-19 and other challenging situations. It was hosted by the Uganda Cancer Institute and the Palliative Care Association of Uganda (UCI-PCAU). The conference was held virtually, with a mix of pre-recorded sessions, plenary sessions being broadcast live on television (TV) by the Uganda Broadcasting Corporation TV, live speakers at the studio and others presenting in real time via Zoom. The conference brought together >350 participants who participated on Zoom, along with those attending in person at the studio and those watching the plenary sessions on TV. At the heart of this joint UCI-PCAU conference was the commitment to not only continue but to improve the provision of cancer care and palliative care within Uganda. Key themes from the conference included: the importance of Universal Health Coverage; the impact of COVID-19 on the provision of cancer and palliative care; that both cancer care and palliative care are available in Uganda; education for all; the importance of working together to provide care and overcome challenges, e.g. through technology; the resilience shown by those working in cancer and palliative care; the grief experienced by so many people who have lost loved ones during the pandemic; the importance of good health seeking behaviour – prevention is better than cure; the challenge of funding; the need for health care equity for marginalised and vulnerable populations and finally we can’t wait for the world to stop COVID-19 – COVID-19 is here to stay – we need to find solutions. The last few years have seen significant challenges due to the COVID-19 pandemic; however, despite this, cancer and palliative care service provision has continued. This conference, whilst unique and very different from previous conferences, was a great opportunity to share not only amongst each other, but also to share key messages with the public through the live broadcasting of the plenary sessions of the conference.
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Affiliation(s)
- Julia Downing
- International Children's Palliative Care Network, Suite 1b, Whitefrairs, Lewins Mead, Bristol BS1 2NT, UK.,Palliative care Education and Research Consortium, PO Box 6245, Kyadondo Block 262, Plot 9, Kibuye, Makindye, Kampala, Uganda.,Makerere University, University Rd, Kampala, Uganda
| | - Nixon Niyonzima
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda
| | | | | | - Henry Ddungu
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda.,Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Lisa Christine Irumba
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Ludoviko Zirimenya
- MRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59, Nakiwogo Road, Entebbe, Uganda
| | | | | | | | - Margaret Happy
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda
| | - Alfred Jatho
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda
| | | | - Cynthia Kabagambe
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Collins Mpamani
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda
| | - Zaitun Nalukwago
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Zipporah Kyomuhangi
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Joyce Zalwango
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
| | - Jackson Orem
- Uganda Cancer Institute, Upper Mulago Hill Rd, Kampala, Uganda
| | - Mark Mwesiga
- Palliative Care Association of Uganda, Block 383, Plot 8804, Kitende, Entebbe Road, Uganda
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Wahidie D, Altinok K, Yılmaz-Aslan Y, Brzoska P. [Strategies, guidelines and recommendations for coping with the COVID-19 pandemic in palliative and hospice care facilities. Results of a scoping review]. Z Gerontol Geriatr 2022; 55:151-156. [PMID: 35061068 PMCID: PMC8780045 DOI: 10.1007/s00391-022-02016-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022]
Abstract
Hintergrund Palliativ- und Hospizeinrichtungen sind durch die COVID-19-Pandemie besonderen Herausforderungen ausgesetzt. Gründe dafür sind insbesondere das hohe Alter und bestehende Vorerkrankungen der Patienten sowie ein körperlich naher Kontakt zwischen Mitarbeitern und Patienten. Ziel der Arbeit Ziel der vorliegenden Studie ist es, bestehende Strategien, Richtlinien und Empfehlungen zum Umgang mit den Herausforderungen der COVID-19-Pandemie in der Palliativ- und Hospizversorgung zu ermitteln, die in Deutschland und anderen Ländern zum Einsatz kommen. Material und Methoden Im Rahmen eines Scoping Reviews wurden die Datenbanken PubMed, CINAHL, Web of Science und PsycInfo durchsucht. Zusätzlich wurde „graue Literatur“ über Google Search und Google Scholar recherchiert. Eingeschlossen wurden alle deutsch- und englischsprachigen Artikel im Zeitraum Januar 2020 bis August 2021, die sich auf die stationäre Palliativ- und Hospizversorgung beziehen. Ergebnisse Insgesamt wurden 51 Veröffentlichungen in die Analyse aufgenommen. Die identifizierten Maßnahmen lassen sich 10 verschiedenen Kategorien zuordnen: Maßnahmen zur Infektionskontrolle, strukturelle Maßnahmen, Besuchsregelungen, Kommunikationsstrukturen, Schulung und Aufklärung, psychosoziale Unterstützungsmaßnahmen, spezifische Überlegungen für Menschen mit Demenz, vorausschauende Pflegeplanung, Abschiednahme sowie Maßnahmen nach dem Tod. Diskussion Bei der Bewältigung der COVID-19-Pandemie dominieren insbesondere Maßnahmen zur Ermöglichung der Kommunikation zwischen Patienten, Mitarbeitern und Angehörigen, psychosoziale Unterstützungsmaßnahmen, strukturelle Maßnahmen und Empfehlungen zur Schulung und Aufklärung aller Beteiligten. Strategien zur Palliativversorgung von Menschen mit Demenz in Pandemiezeiten sowie zu Abschiednahme und Trauerbewältigung von Hinterbliebenen finden weniger Beachtung. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-022-02016-8) enthalten.
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Affiliation(s)
- Diana Wahidie
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland
| | - Kübra Altinok
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland
| | - Yüce Yılmaz-Aslan
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland.,Fakultät für Gesundheitswissenschaften, AG3 Epidemiologie & International Public Health, Universität Bielefeld, Bielefeld, Deutschland.,Fakultät für Gesundheitswissenschaften, AG6 Versorgungsforschung und Pflegewissenschaft, Universität Bielefeld, Bielefeld, Deutschland
| | - Patrick Brzoska
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland.
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Sangalli L, Fernandez-Vial D, Moreno-Hay I, Boggero I. Telehealth Increases Access to Brief Behavioral Interventions in Orofacial Pain Clinic during COVID-19 Pandemic: A Retrospective Study. PAIN MEDICINE 2021; 23:799-806. [PMID: 34623433 PMCID: PMC8524454 DOI: 10.1093/pm/pnab295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/09/2021] [Accepted: 10/04/2021] [Indexed: 01/25/2023]
Abstract
Objective Aim of the study was to test if orofacial pain patients were more likely to start and complete a brief psychological intervention for managing certain chronic orofacial pain conditions (physical self-regulation, PSR) via telehealth (during the COVID-19 pandemic) vs. in-person (prior to the COVID-19 pandemic). Exploratory aim was to describe demographic factors that may influence the patients to start and complete PSR. Methods Retrospective medical charts of all patients seen at a university-affiliated tertiary orofacial pain clinic between July–December 2019 (in person, pre-pandemic) and July–December 2020 (telehealth, during pandemic) were reviewed. Charts were examined for demographic information and to compare the number of patients who started and completed PSR during each study period (chi-squared test). Results Of 248 new patients seen in the clinic during 2019 period, 25 started PSR in-person (10.08%). Of 252 new patients seen during 2020 period, 53 started PSR via telehealth (21.03%). Patients were more likely to start PSR (OR = 6.21, p<.001, CI = 2.499 to 15.435) and more likely to complete all three sessions of PSR (OR = 5.69, p<.001, CI = 2.352 to 13.794) when it was offered via telehealth than in-person. Among those who started PSR via telehealth, patients from metropolitan areas were more likely to start the intervention than those from non-metropolitan areas (p=.045). Conclusions Offering brief psychological pain interventions via telehealth in tertiary orofacial pain clinics has demonstrated feasibility and may improve willingness to participate in psychological treatments. Results need to be replicated with prospective data as modality was confounded with pandemic in the current study.
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Affiliation(s)
- Linda Sangalli
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Diego Fernandez-Vial
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Isabel Moreno-Hay
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Ian Boggero
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
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Pastrana T, De Lima L, Pettus K, Ramsey A, Napier G, Wenk R, Radbruch L. Impact of COVID-19 Pandemic on Palliative Care Workers: An International Cross-sectional Study. Indian J Palliat Care 2021; 27:299-305. [PMID: 34511800 PMCID: PMC8428902 DOI: 10.25259/ijpc_6_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/01/2022] Open
Abstract
Objectives: The COVID-19 pandemic and the measures taken to mitigate spread have affected countries in different ways. Healthcare workers, in particular, have been impacted by the pandemic and by these measures. This study aims to explore how COVID-19 has impacted on palliative care (PC) workers around the world. Materials and Methods: Online survey to members of the International Association for Hospice and PC during the initial months of the COVID-19 pandemic. Convenience sampling was used. Statistical descriptive and contingency analyses and Chi-square tests with P < 0.05 were conducted. Results: Seventy-nine participants (RR = 16%) from 41 countries responded. Over 93% of those who provide direct patient care reported feeling very or somewhat competent in PC provision for patients with COVID-19. Eighty-four felt unsafe or somewhat safe when caring for patients with COVID-19. Level of safety was associated with competence (P ≤ 0.000). Over 80% reported being highly or somewhat affected in their ability to continue working in their PC job, providing care to non-COVID patients and in staff availability in their workplace. About 37% reported that availability and access to essential medicines for PC were highly or somewhat affected, more so in low-income countries (P = 0.003). Conclusion: The results from this study highlight the impact of COVID-19 on the provision of PC. It is incumbent on government officials, academia, providers and affected populations, to develop and implement strategies to integrate PC in pandemic response, and preparedness for any similar future events, by providing appropriate and comprehensive education, uninterrupted access to essential medicines and personal protective equipment and ensure access to treatment and care, working together with all levels of society that is invested in care of individuals and populations at large. The long-term effects of the pandemic are still unknown and future research is needed to monitor and report on the appropriateness of measures.
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Affiliation(s)
- Tania Pastrana
- Department of Palliative Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
| | - Katherine Pettus
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
| | - Alison Ramsey
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
| | - Genevieve Napier
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
| | - Roberto Wenk
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
| | - Lukas Radbruch
- International Association for Hospice and Palliative Care, Houston, Taxes, United States
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Afolabi OA, Abboah-Offei M, Namisango E, Chukwusa E, Oluyase AO, Luyirika EB, Harding R, Nkhoma K. COVID-19 and palliative care capacity, African Region. Bull World Health Organ 2021; 99:542-542A. [PMID: 34354305 PMCID: PMC8319866 DOI: 10.2471/blt.20.285286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Oladayo A Afolabi
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
| | - Mary Abboah-Offei
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
| | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
| | - Emeka Chukwusa
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
| | - Adejoke O Oluyase
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
| | | | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
| | - Kennedy Nkhoma
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, Bessemer Road, London, SE5 9PJ England
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Lin CP, Boufkhed S, Kizawa Y, Mori M, Hamzah E, Aggarwal G, Namisango E, Higginson IJ, Goh C, Harding R. Preparedness to Face the COVID-19 Pandemic in Hospice and Palliative Care Services in the Asia-Pacific Region: A Rapid Online Survey. Am J Hosp Palliat Care 2021; 38:861-868. [PMID: 33789503 DOI: 10.1177/10499091211002797] [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: 01/10/2023] Open
Abstract
BACKGROUND Hospice and palliative care services provision for COVID-19 patients is crucial to improve their life quality. There is limited evidence on COVID-19 preparedness of such services in the Asia-Pacific region. AIM To evaluate the preparedness and capacity of hospice and palliative care services in the Asia-Pacific region to respond to the COVID-19 pandemic. METHOD An online cross-sectional survey was developed based on methodology guidance. Asia-Pacific Hospice and Palliative Care Network subscribers (n = 1551) and organizational members (n = 185) were emailed. Descriptive analysis was undertaken. RESULTS Ninety-seven respondents completed the survey. Around half of services were hospital-based (n = 47, 48%), and public-funded (n = 46, 47%). Half of services reported to have confirmed cases (n = 47, 49%) and the majority of the confirmed cases were patients (n = 28, 61%). Staff perceived moderate risk of being infected by COVID-19 (median: 7/10). > 85% of respondents reported they had up-to-date contact list for staff and patients, one-third revealed challenges to keep record of relatives who visited the services (n = 30, 31%), and of patients visited in communities (n = 29, 30%). Majority of services (60%) obtained adequate resources for infection control except face mask. More than half had no guidance on Do Not Resuscitate orders (n = 59, 66%) or on bereavement care for family members (n = 44, 51%). CONCLUSION Recommendations to strengthen the preparedness of palliative care services include: 1) improving the access to face mask; 2) acquiring stress management protocols for staff when unavailable; 3) reinforcing the contact tracing system for relatives and visits in the community and 4) developing guidance on patient and family care during patient's dying trajectory.
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Affiliation(s)
- Cheng-Pei Lin
- Institute of Community Health Care, School of Nursing, 34882National Yang Ming Chiao Tung University, Taipei, Taiwan.,Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Yoshiyuki Kizawa
- Department of Palliative Medicine, 12885Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Mori
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | | | - Eve Namisango
- 108118African Palliative Care Association, Kampala, Uganda
| | - Irene J Higginson
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
| | - Cynthia Goh
- Division of Supportive and Palliative Care, 68751National Cancer Centre, Singapore, Singapore Cheng-Pei Lin and Sabah Boufkhed are joint first authors
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, 4616King's College London, London, UK
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Boufkhed S, Harding R, Kutluk T, Husseini A, Pourghazian N, Shamieh O. What Is the Preparedness and Capacity of Palliative Care Services in Middle-Eastern and North African Countries to Respond to COVID-19? A Rapid Survey. J Pain Symptom Manage 2021; 61:e13-e50. [PMID: 33227380 PMCID: PMC7679234 DOI: 10.1016/j.jpainsymman.2020.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/12/2020] [Accepted: 10/23/2020] [Indexed: 01/10/2023]
Abstract
CONTEXT Evidence from prior public health emergencies demonstrates palliative care's importance to manage symptoms, make advance care plans, and improve end-of-life outcomes. OBJECTIVE To evaluate the preparedness and capacity of palliative care services in the Middle-East and North Africa region to respond to the COVID-19 pandemic. METHODS A cross-sectional online survey was undertaken, with items addressing the WHO International Health Regulations. Nonprobabilistic sampling was used, and descriptive analyses were conducted. RESULTS Responses from 43 services in 12 countries were analyzed. Half of respondents were doctors (53%), and services were predominantly hospital based (84%). All but one services had modified at least one procedure to respond to COVID-19. Do Not Resuscitate policies were modified by a third (30%) and unavailable for a fifth (23%). While handwashing facilities at points of entry were available (98%), a third had concerns over accessing disinfectant products (37%), soap (35%), or running water (33%). The majority had capacity to use technology to provide remote care (86%) and contact lists of patients and staff (93%), though only two-fifths had relatives' details (37%). Respondents reported high staff anxiety about becoming infected themselves (median score 8 on 1-10 scale), but only half of services had a stress management procedure (53%). Three-fifths had plans to support triaging COVID-19 patients (60%) and protocols to share (58%). CONCLUSION Participating services have prepared to respond to COVID-19, but their capacity to respond may be limited by lack of staff support and resources. We propose recommendations to improve service preparedness and relieve unnecessary suffering.
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Affiliation(s)
- Sabah Boufkhed
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Richard Harding
- Cicely Saunders Institute, Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Tezer Kutluk
- Department of Pediatric Oncology Hacettepe University Faculty of Medicine and Cancer Institute, Ankara, Turkey
| | - Abdullatif Husseini
- Institute of Community and Public Health, Birzeit University, Birzeit, Palestine
| | - Nasim Pourghazian
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Omar Shamieh
- Center for Palliative & Cancer Care in Conflict, Department of Palliative Care, King Hussein Cancer Center, Amman, Jordan; College of Medicine, The University of Jordan, Amman, Jordan
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Lin CP, Boufkhed S, Pai AA, Namisango E, Luyirika E, Sleeman KE, Costantini M, Peruselli C, Higginson IJ, Ekstrand ML, Harding R, Salins N, Bhatnagar S. Preparedness and Capacity of Indian Palliative Care Services to Respond to the COVID-19 Pandemic: An Online Rapid Assessment Survey. Indian J Palliat Care 2021; 27:152-171. [PMID: 34035634 PMCID: PMC8121233 DOI: 10.4103/ijpc.ijpc_429_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 12/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND COVID-19 has been causing a high burden of suffering for patients and families. There is limited evidence on the preparedness of Indian palliative care services for the pandemic. AIM This study aimed to assess the preparedness and capacity of Indian palliative care services in response to the COVID-19 pandemic. METHODS A cross-sectional online survey was developed based on prior evidence and international health regulations. It was emailed to the Indian Palliative Care Association members and investigators' professional networks in India. One participant per palliative care service was requested. Descriptive analysis was used. RESULTS Representatives of 78 palliative care services completed the survey. Three in four services had COVID-19 case definition and adapted their protocols for infection control (75%). About half of the services (55%) reported concerns about achieving appropriate hand hygiene in the community. More than half of the services (59%) had capacity to train nonspecialists for symptom control and psychological support. About half of the services reported that they had plans to redeploy staff (56%) and resources (53%) in the case of outbreaks. Two-fifths of the services used paper records to store an updated contact list of staff (40%) and did not have designated focal contacts for information update (40%). Staff anxiety related to personal infection risk and family care was relatively high (median score = 7 on a 1-10 scale). CONCLUSION We recommend the following resource allocation to enable palliative care services to support the Indian health system in delivering essential care in this and future pandemics: (1) infection control, especially in the community; (2) training using existing clinical protocols to strengthen palliative care across the health system; and (3) redeployment plans.
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Affiliation(s)
- Cheng-Pei Lin
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
- School of Nursing, Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan
| | - Sabah Boufkhed
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Asha Albuquerque Pai
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Eve Namisango
- African Palliative Care Association, Kampala, Uganda
| | | | - Katherine E Sleeman
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | | | - Carlo Peruselli
- Società Italiana di Cure Palliative (Italian Society of Palliative Care), MI, Italy
| | - Irene J Higginson
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Maria L Ekstrand
- Department of Medicine, Division of Prevention Science, University of California, San Francisco, USA
- St John's Research Institute, Bengaluru, Karnataka, India
| | - Richard Harding
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Cicely Saunders Institute, King's College London, London, UK
| | - Naveen Salins
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sushma Bhatnagar
- Department of Oncoanesthesia and Palliative Medicine, All India Institute of Medical Sciences, New Delhi, India
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