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Integrated primary palliative care in Nigeria- perspectives of patients, families and providers

Research output: Contribution to journalArticlepeer-review

Oladayo A Afolabi, Kennedy Nkhoma, Olaitan Soyannwo, Akinyemi Aje, Adesola Ogunniyi, Richard Harding, Matthew Maddocks

Original languageEnglish
Pages (from-to)319-329
Number of pages11
JournalJournal of pain and symptom management
Volume64
Issue number4
Early online date11 Jul 2022
DOIs
Accepted/In press30 Jun 2022
E-pub ahead of print11 Jul 2022

Bibliographical note

Funding Information: OA is funded by the King's International Postgraduate Research Scholarship and the Gilchrist Educational Trust Travel Grant. Funding Information: MM is funded by a National Institute for Health Research (NIHR) Career Development Fellowship (CDF-2017–10-009) and supported by the NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed in this article are those of the authors and not necessarily those of the NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2022 The Authors

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Abstract

Background: Palliative care should be integrated into primary healthcare systems within low- and middle-income countries to achieve Universal Health Coverage goals. We aimed to identify preferences and expectations for primary palliative care among people living with serious illness and their families and the readiness of primary healthcare providers to deliver primary palliative care in Nigeria. Methods: Qualitative descriptive interview study with 48 participants: people living with serious illness (n=21) and their family caregivers (n=15), healthcare providers (n=12). Data were analysed using thematic analysis. Results: Three major themes were identified. 1.) Engaging patients and families. 2.) Managing patients and families’ expectations and preferences. 3.) Addressing staffing-related issues. Patients and families have existing trust and bonds from using primary healthcare but lack individual agency necessary for person-centered care decisions. They expect an easily accessible service, opportunities for social interaction and adequate communication. Development of healthcare providers is needed to ensure an appropriate clinical response, manage interprofessional trust and ensure clear role delineation. Conclusions: Our findings have identified specific approaches to implement the WHO policy on integrated primary palliative care. Palliative care integration within primary healthcare in Nigeria can be achieved through building information and communication skills of healthcare providers, engaging and empowering patients to exercise their agency in care decisions, and adequately delineating healthcare providers’ roles to ensure staff work within their competencies and training.

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