Providing Palliative Care in Rural Nepal: Perceptions of Mid-Level Health Workers
Providing Palliative Care in Rural Nepal: Perceptions of Mid-Level Health Workers
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DOI：
10.4103/ijpc.ijpc_196_17
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发表时间：
2018-04-01
影响因子：
1.1
通讯作者：
Kernohan, George W.
中科院分区：
文献类型：
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作者：
Gongal, Rajesh N.;Upadhyay, Shambhu Kumar;Kernohan, George W.
导语：尼泊尔开始在全国范围内开展姑息治疗服务。大多数人生活在农村地区，那里的中层卫生工作者是主要的服务提供者。他们对提供姑息治疗的看法是决定如何组织和发展这项服务的最重要的因素。目的：本研究旨在了解卫生保健部在当地社区对姑息治疗的看法，为服务发展提供资讯。方法：采用定性描述性设计，使用焦点小组讨论，从尼泊尔75个区中的1个Makwanpur农村区收集数据。28名卫生保健工作者参加了四次焦点小组讨论。采用内容分析法对数据进行分析。结果：讨论产生了四个主题：(I)危及生命的疾病给患者及其家人带来的痛苦，(Ii)护理此类患者时的无助和挫折感，(Iii)生命末期的社会文化问题，以及(Iv)改善对有姑息护理需求的患者的护理。结论：在农村执业的卫生保健工作者反映了由于贫困、贫困、资源匮乏、社会歧视、卫生工作者知识和技能缺乏等原因导致的生命受限疾病患者及其家人的痛苦。虽然人们显然对有限的资源感到失望，但卫生工作者愿意学习，并在社区提供护理。
Introduction: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs) are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed. Aim: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development. Methods: A qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal. Twenty-eight MHWs participated in four focus group discussions. The data were analyzed using content analysis. Result: Four themes emerged from the discussion: (i) suffering of patients and families inflicted by life-threatening illness, (ii) helplessness and frustration felt when caring for such patients, (iii) sociocultural issues at the end of life, and (iv) improving care for patients with palliative care needs. Conclusion: MHWs practicing in rural areas reported the suffering of patients inflicted with life-limiting illness and their family due to poverty, poor access, lack of resources, social discrimination, and lack of knowledge and skills of the health workers. While there are clear frustrations with the limited resources, there is a willingness to learn among the health workers and provide care in the community.