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Alshehri AM, Almogbel YS, Alonazi RE, Alshehri WM, Alkhelaifi HA, Almutairi SA, Alenazi OS, Alali AZ. Pharmacists' Knowledge and Intention to Provide Palliative Care Services in Saudi Arabia: Using the Theory of Planned Behaviour. Healthcare (Basel) 2023; 11:2173. [PMID: 37570413 PMCID: PMC10418381 DOI: 10.3390/healthcare11152173] [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: 04/20/2023] [Revised: 06/17/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Providing palliative care to patients with life-threatening illnesses requires multidisciplinary efforts from different healthcare providers. Identifying the attitude, knowledge, and intentions of pharmacists to provide this service in Saudi Arabia is essential. Therefore, this study aimed to identify the palliative care knowledge, intentions, attitudes, subjective norms, and perceived behavioural control of pharmacists and what factors predict their intentions. Cross-sectional questionnaires based on the theory of planned behaviour were distributed to pharmacists in hospitals and community pharmacies. They included items that measured palliative care knowledge, attitudes, intentions, subjective norms, and the perceived behavioural control of pharmacists and identified other sociodemographic and pharmacy-practice-related items. In total, 131 pharmacists completed the questionnaires, showing an average score on palliative knowledge (8.82 ± 1.96; range: 1-14), strong intentions (5.84 ± 1.41; range: 1-7), positive attitudes (6.10 ± 1.47; range: 1-7), positive subjective norms (5.31 ± 1.32; range: 1-7), and positive perceived behavioural control (5.04 ± 1.21; range: 1-7). Having completed a pharmacy residency program, working longer hours per week, having a more positive attitude, and perceived stronger subjective norms were significantly associated with a strong intention to provide palliative care services. Therefore, enabling and motivating pharmacists to complete pharmacy residency programs and improve their attitudes could increase their intentions to provide these services.
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Affiliation(s)
- Ahmed M. Alshehri
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Yasser S. Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia;
| | - Rana E. Alonazi
- Pharmacology Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia;
| | - Waleed M. Alshehri
- Clinical Pharmacy Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Hind A. Alkhelaifi
- Contracts Management Department, National Unified Procurement Company (NUPCO), Riyadh 12251, Saudi Arabia;
| | - Salman A. Almutairi
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Omar S. Alenazi
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Ali Z. Alali
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
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Ojedoyin OE, Jegede AS. A quantitative study of nurses perception to advance directive in selected private and public secondary healthcare facilities in Ibadan, Nigeria. BMC Med Ethics 2022; 23:87. [PMID: 36008832 PMCID: PMC9404628 DOI: 10.1186/s12910-022-00825-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/16/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives The study evaluated nurses’ perceptions on the benefits, drawbacks, and their roles in initiating and implementing advance directives (AD) at private and public secondary healthcare units. Methods The study adopted a cross-sectional, comparative-descriptive research design and was anchored on the structural functional theory. A total of 401 nurses (131 private and 270 public) were chosen on purpose. The data was collected between January and March 2018 among nurses at the selected hospitals. Analysis was done via SPSSv28.0.1.0. Results Compared to nurses working in private healthcare facilities (72.5%), the majority of nurses at the public healthcare facilities (75.2%) indicated a more favorable opinion of AD’s benefits and (61.9%) felt they had a substantial involvement in the development and execution of AD than their private counterpart (56.5%). Similarly, 60.7% of nurses employed by the government agreed that AD has some disadvantages compared to those employed by the private sector (58.8%). Significantly, Christian nurses are 0.53 times less likely than Muslims to contest AD’s benefits; 0.78 times less likely than Muslim to disagree that AD has flaws; and 1.30 times more likely than Muslim nurses to deny they contributed to the development and execution of AD, though not significant. Conclusion Making decisions at the end-of-life can be challenging, thus AD should be supported across the board in the healthcare industry. Nurses should be trained on their role in developing and implementing AD, as well as on its advantages and how to deal with its challenges.
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Oji N, Onyeka T, Soyannwo O, Paal P, Elsner F. Perspectives, perceived self-efficacy, and preparedness of newly qualified physicians' in practising palliative care-a qualitative study. Palliat Care 2022; 21:141. [PMID: 35922778 PMCID: PMC9351146 DOI: 10.1186/s12904-022-01028-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dealing with life-limiting illnesses, death, dying and grief, is uncharted territory for medical graduates. It is a field that is heavily influenced by cultural, religio-spiritual and social factors. This adds complexity to palliative and end-of-life-care, which challenges newly qualified physicians and requires the formation of appropriate knowledge, skills, and attitudes in junior doctors. This study aimed to obtain insight into the perspectives, perceived self-efficacy, and preparedness of newly qualified Nigerian physicians in practising palliative care and identify potential variables influencing them. METHODS The study was a cross-sectional, multi-centre survey of newly qualified Nigerian physicians, using semi-structured, in-depth qualitative interviews. The data were analysed by applying content-structuring qualitative content analysis. RESULTS Forty semi-structured interviews were conducted with medical house officers at two tertiary institutions in Nigeria. The perceived self-efficacy and preparedness of newly qualified Nigerian physicians in practising palliative care were reported to be higher in areas of family involvement, and pain and symptom management than in areas of breaking bad news, prognosis, and diagnosing dying. Major influences on the young physicians' perceived self-efficacy and preparedness in practising palliative care were socio-economic circumstances of a resource-limited setting and cultural-religious considerations. In addition, the perceived impact of palliative care education and experience was documented. CONCLUSIONS This study offers valuable insights into the perceived self-efficacy and preparedness of newly qualified physicians and reveals the influence of socio-cultural and socio-economic variables in Nigeria. Evidence of the social, cultural, and religio-spiritual dimensions of palliative care is indispensable for culturally sensitive care. These results could aid in the development of appropriate knowledge, skills, and attitudes in newly qualified physicians through culturally and contextually appropriate palliative care training measures. The results may be applicable to other sub-Saharan African settings and may be used to improve future palliative care education, training, and practice.
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Affiliation(s)
- Nwabata Oji
- Department of Palliative Medicine, Uniklinik RWTH Aachen, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 57, 52074, Aachen, Germany.
| | - Tonia Onyeka
- Department of Anaesthesia / Pain and Palliative Care Unit, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Olaitan Soyannwo
- Hospice and Palliative Care Department, University College Hospital Ibadan, Queen Elizabeth Road, Ibadan, Oyo State, Nigeria
| | - Piret Paal
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Frank Elsner
- Department of Palliative Medicine, Uniklinik RWTH Aachen, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 57, 52074, Aachen, Germany
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Rohilla K, Ranga K, Ranga U, Kalyani CV. Descriptive cross-sectional study to assess the knowledge of undergraduate nurses of predictors of palliative care. CANCER RESEARCH, STATISTICS, AND TREATMENT 2022. [DOI: 10.4103/crst.crst_261_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Getie A, Wondmieneh A, Mengesha A, Fitwi A, Gedefaw G, Demis A. Assessment of Knowledge and Attitude towards Palliative Care and Associated Factors among Nurses Working in North Wollo Hospitals. Ethiop J Health Sci 2021; 31:393-400. [PMID: 34158791 PMCID: PMC8188070 DOI: 10.4314/ejhs.v31i2.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Palliative care improves the quality of life of patients facing a life-threatening illness. Nurses should improve their caregiving capacity. In Ethiopia, palliative care is underestimated. The availability of data regarding the knowledge and attitude of nurses towards palliative care is critically important. Thus, this study aimed to assess the level of knowledge and attitude of nurses towards palliative care. Methods Institution-based, cross-sectional study was conducted in North Wollo hospitals. A simple random sampling technique was used. The data was collected using structured self-administered questionnaires from February to March 2019. The analysis was done using a binary logistic regression model. P-value < 0.05 was considered as statistically significant. Results The result revealed that 59.7% of the respondents had good knowledge and 44.2% had a favorable attitude towards palliative care. Level of education, experience in caring for chronically ill patients, and experience in caring for dying family members within the last 6 months had a significant association with the knowledge of nurses. Monthly income, experience in caring for chronically ill patients, formal palliative care education, and knowledge were found statistically significant with the attitude of nurses towards palliative care. Conclusion More than half of the nurses had good knowledge, but less than half of the respondents had a favorable attitude towards palliative care. Attention should be given towards palliative care by the health policy and needs to be incorporated into the national curriculum of nursing education.
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Affiliation(s)
- Addisu Getie
- Department of nursing, college of health science, Woldia University, Woldia, Ethiopia
| | - Adam Wondmieneh
- Department of nursing, college of health science, Woldia University, Woldia, Ethiopia
| | - Ayelign Mengesha
- Department of nursing, college of health science, Woldia University, Woldia, Ethiopia
| | - Awet Fitwi
- Department of nursing, college of health science, Woldia University, Woldia, Ethiopia
| | - Getnet Gedefaw
- Department of midwifery, college of health science, Woldia University, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of nursing, college of health science, Woldia University, Woldia, Ethiopia
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Agom DA, Onyeka TC, Iheanacho PN, Ominyi J. Barriers to the Provision and Utilization of Palliative Care in Africa: A Rapid Scoping Review. Indian J Palliat Care 2021; 27:3-17. [PMID: 34035611 PMCID: PMC8121217 DOI: 10.4103/ijpc.ijpc_355_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 10/18/2020] [Indexed: 11/04/2022] Open
Abstract
Palliative care (PC) has continued to be less available, underutilized, and unintegrated in many of the healthcare systems, especially in Africa. This scoping review synthesized existing published papers on adult PC in Africa, to report the barriers to PC and to assess the methodologies used in these studies. Eight electronic databases and Google Scholar were searched to identify relevant studies published between 2005 and 2018. Overall, 42 publications (34 empirical studies and 9 reviews) that reported issues related to barriers to adult PC were selected. Three themes identified were individual-level, system-level, and relational barriers. The studies reviewed predominantly utilized cross-sectional and retrospective study design, underscoring the need for more studies employing qualitative design. Findings highlight the need for health education, training opportunities, more funding, communication, and timely referral. Future works could focus on underlying factors to these barriers and ethno-religious perspectives to PC in Africa.
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Affiliation(s)
- David A Agom
- Department of Nursing, Faculty of Health and Society, University of Northampton, Northampton, United Kingdom
- Department of Nursing, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria
| | - Tonia C Onyeka
- Department of Anaesthesia/Pain and Palliative Care Unit, Multidisciplinary Oncology Centre, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Peace N Iheanacho
- Department of Nursing Sciences, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Jude Ominyi
- Department of Nursing, Faculty of Health and Society, University of Northampton, Northampton, United Kingdom
- Department of Nursing, Faculty of Health Science and Technology, Ebonyi State University, Abakaliki, Nigeria
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An Integrative Review on Knowledge and Attitudes of Nurses Toward Palliative Care: Implications for Practice. J Hosp Palliat Nurs 2020; 21:29-37. [PMID: 30608355 DOI: 10.1097/njh.0000000000000481] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To effectively participate in provision of palliative care, nurses need to possess a combination of knowledge, skills, and positive attitudes in equal measure in a way that is sensitive and meaningful and in a dynamic manner. The aim of this review was to examine nurses' knowledge and attitudes about palliative care, to identify gaps to improve care of patients and families facing death. An integrative review method guided this review. After implementation of a search strategy, data from 26 studies were analyzed and synthesized. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. Data were extracted using a common table, and themes were generated from the available peer-reviewed studies using narrative synthesis. Findings revealed knowledge deficit but favorable attitudes toward palliative care among nurses. Education and the clinical experience of nurses in palliative care influenced their knowledge and attitudes toward palliative care. There is a need for mandatory inclusion of basic palliative care content in nursing school curricula and more in-depth postgraduate curricula. In clinical practice, there is a need to reinforce palliative care education by creating expert nurse support networks to model excellence in palliative care.
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Adisa R, Anifowose AT. Pharmacists' knowledge, attitude and involvement in palliative care in selected tertiary hospitals in southwestern Nigeria. BMC Palliat Care 2019; 18:107. [PMID: 31783834 PMCID: PMC6884848 DOI: 10.1186/s12904-019-0492-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 11/20/2019] [Indexed: 02/08/2023] Open
Abstract
Background The growing number of people living with life-limiting illness is a global health concern. This study therefore aimed to explore the involvement of pharmacists in selected tertiary hospitals in Nigeria in palliative care (PC). It also sought to evaluate their knowledge and attitude to PC as well as factors that hinder pharmacists’ participation in PC. Method Questionnaire-guided survey among pharmacists working in three-tertiary hospitals in southwestern Nigeria. The self-administered questionnaire comprised 18-item general knowledge questions related to PC, attitude statements with 5-point Likert-scale options and question-items that clarify extent of involvement in PC and barriers to participation. Overall score by pharmacists in the knowledge and attitude domains developed for the purpose of this study was assigned into binary categories of “adequate” and “inadequate” knowledge (score > 75% versus≤75%), as well as “positive” and “negative” attitude (ranked score > 75% versus≤75%), respectively. Descriptive statistics, Mann-Whitney-U and Kruskal-Wallis tests were used for analysis at p < 0.05. Results All the 110 pharmacists enrolled responded to the questionnaire, given a response rate of 100%. Overall, our study showed that 23(21.1%) had adequate general knowledge in PC, while 14(12.8%) demonstrated positive attitude, with 45(41.3%) who enjoyed working in PC. Counselling on therapy adherence (100;90.9%) was the most frequently engaged activity by pharmacists; attending clinical meetings to advise health team members (45;40.9%) and giving educational sessions (47;42.7%) were largely cited as occasionally performed duties, while patient home visit was mostly cited (60;54.5%) as a duty not done at all. Pharmacists’ unawareness of their need in PC (86;79.6%) was a major factor hindering participation, while pharmacists with PC training significantly felt more relaxed around people receiving PC compared to those without training (p = 0.003). Conclusion Hospital pharmacists in selected tertiary care institutions demonstrate inadequate knowledge, as well as negative attitude towards PC. Also, extent of involvement in core PC service is generally low, with pharmacists’ unawareness of their need in PC constituting a major barrier. Thus, a need for inclusion of PC concept into pharmacy education curriculum, while mandatory professional development programme for pharmacists should also incorporate aspects detailing fundamental principles of PC, in order to bridge the knowledge and practice gaps.
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Affiliation(s)
- Rasaq Adisa
- Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria.
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Palliative Care: The Nigerian Perspective. Palliat Care 2019. [DOI: 10.5772/intechopen.85235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Badru AI, Kanmodi KK. Palliative care awareness amongst religious leaders and seminarians: a Nigerian study. Pan Afr Med J 2017; 28:259. [PMID: 29881502 PMCID: PMC5989269 DOI: 10.11604/pamj.2017.28.259.14010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 10/11/2017] [Indexed: 11/11/2022] Open
Abstract
Introduction There exists scanty literature on the awareness of Nigerians towards palliative care. This study was conducted to determine the level of awareness of religious leaders and seminarians in Ibadan, Nigeria, on palliative care. Methods Data obtained from a cross-section of 302 religious leaders and seminarians in the metropolitan city of Ibadan, Nigeria, were used in this research. Study tool was a self-administered questionnaire which obtained information from the participants about their bio-data and knowledge of palliative care. Data analysis was done using the SPSS version 16 Software. Results The mean age of the respondents was 28.99 years, with 55.6% of them being within the age range of 21 to 30 years. The majority (94%) were males, 68.5% were single and 79.8% were seminarians. Only 31.8% have heard of palliative care before, 12.6% knew a health facility where palliative care is rendered in Nigeria, while 21.9% knew that chaplains are members of the palliative care team. Conclusion The level of awareness of palliative care among religious leaders and seminarians in Ibadan, Nigeria, is low. There exists the need to educate Nigerian religious leaders and seminarians on palliative care.
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Affiliation(s)
| | - Kehinde Kazeem Kanmodi
- Cephas Health Research Initiative Inc, Ibadan, Nigeria.,Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.,Community Health Officers Training Programme, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
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