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- ItemRestrictedExploration of Attitudes and Factors of Health-care Professionals Contributing to Late Referral of Cancer Patients for Palliative Care Services: A Qualitative Cross-sectional Study at Mulanje District Hospital(Kamuzu University of Health Sciences, 2022-03-04) Lino, Treza; Mnyenyembe, Ezelia; Chawinga, Judith; Beza, ChawanangwaType of research study: This will be a cross-sectional qualitative study, aiming at exploring attitudes and factors of Medical Doctors, Nurses and Clinical Officers contributing to late referral of cancer patients for palliative care services at Mulanje District Hospital. The Research problem: Cancer patients are usually referred late for palliative care services; and this delays the goal of improving the quality of life of patients from the point of diagnosis. It is important to understand some of the challenges that are responsible for late referral of palliative care patients. This study seeks to generate perspectives from the healthcare providers’ point of view. Findings from the study will be used to propose strategies that could promote early referral of patients in need of palliative care. Objectives: The broad objective of the study is to explore the attitudes of health care workers contributing towards late referral of cancer patients to palliative care services. The specific objectives of the study are: To assess the knowledge of nurses, clinicians and doctors about palliative care services; to assess how cancer patients are referred to palliative care services; to explore the attitudes that delay palliative care referrals and to explore the challenges that delay referral of cancer patients. Methodology: This will be a qualitative cross-sectional study that aims at exploring the attitudes and factors of health care professionals contributing to late referral of cancer patients for palliative care services at Mulanje District Hospital. The study population will be medical doctors, nurses and clinical officers who are providing direct care patients. These will be recruited purposively between 10 and 14 until data saturation is reached. Expected findings and their dissemination Findings of the project will help better understand some of the causes of late referral of cancer patients. Recommendation will therefore focus on strategies to improve referral mechanism. The dissemination of the research findings will include: sharing the results with COMREC, KUHES faculty members; reporting the research findings to COMREC; presentation of results to college of Medicine Research Dissemination Conference (COM- RDC), department of family medicine, Mulanje District Hospital, and international conferences. The results will be published in reputable palliative care online journals.
- ItemRestrictedThe difficulty of breaking bad news: Experiences and perspectives of paediatric of healthcare workers at Queen Elizabeth Central Hospital in Malawi(Kamuzu University of Health Sciences, 2022-02-08) Couri, JonathanType of Study: Mixed methods case study Problem: Paediatric healthcare workers at QECH may or may not initiate palliative care discussions with patients and family members at the time of diagnosis, which can lead to the development of multiple communication challenges. The biggest challenge involves paediatric healthcare workers not effectively breaking bad news to patients and their families. Some are not taking the time to break bad news and to be the needed presence that enables patients and families to overcome the physical, mental, and emotional barriers caused by advancing illness. Due to the emotionally and psychologically complex nature of breaking bad news, paediatric healthcare workers need to be consistently engaged in the process of breaking bad news to promote individuals’ digestion and retention of important information (diagnosis, prognosis, etc.) and to provide the necessary support to paediatric patients and families throughout the continuum of care. To achieve this, there is a need to understand the experiences and perspectives of paediatric healthcare workers and to identify the barriers they face in breaking bad news to patients and their families. Objectives: Our main goal is to understand the challenges paediatric healthcare workers experience in breaking bad news to paediatric patients and their families at QECH. We aim to describe how comfortable and confident paediatric healthcare workers believe they are when breaking bad news to patients and their families. We also hope to understand paediatric healthcare workers’ perceptions of their role in breaking bad news. We then intend to unearth factors influencing the inconsistent breaking of bad news by paediatric healthcare workers to patients and their families. From our data, we will make recommendations for improving the process of breaking bad news to paediatric patients and their families. Methodology: We plan to conduct an initial survey to obtain a general overview of paediatric healthcare workers’ experience in breaking bad news and to identify the scope of palliative care training received by paediatric healthcare workers at QECH. The survey will be sent to all paediatric healthcare workers within QECH, which includes approximately fifty individuals. Following the initial survey, open-ended, semi-structured, in-depth interviews will be conducted with fifteen of the respondents. Expected Findings and Dissemination: Findings of this study will help inform palliative care practice at QECH and similar settings locally and internationally. All results will be presented in report form. A copy of the final report will be submitted to all research partners and the College of Medicine Research Ethics Committee (COMREC). Additionally, a report will be submitted to the Glynn Family Honors Program at the University of Notre Dame in Notre Dame, IN USA.