Recommendations to guide implementation of palliative care services among patients with cervical cancer
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University of South Africa (UNISA) - Ethiopia Regional Learning Center, Addis Ababa, Ethiopia
University of South Africa (UNISA), Pretoria, South Africa
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1432
Background and objectives: Due to increasing trends in non-communicable diseases and the aged population, our community has a high demand for palliative care. The World Health Organization (WHO) estimates that over 40 million people need palliative care, among which only 14% receive it. In this study, we studied the palliative care service provision for cervical cancer patients and provided pertinent recommendations on how best the service could be provided.  Methods: A cross-sectional study was conducted at a tertiary hospital in Addis Ababa, Ethiopia, in 2019 to evaluate the level of palliative care for patients with advanced cervical cancer. Using a pretested and structured questionnaire, a random sample of patients was interviewed by trained hospital nurses. A review of literature, including WHO guidelines, national palliative care strategies, and country-level guidelines, was also systematically conducted to identify critical areas recommended for implementation. Experts from the ministry of health, hospitals, and universities reviewed and provided comments on this study. Results: A total of 385 patients were successfully interviewed for this study. Only about a quarter of the patients have adequate knowledge of comprehensive palliative care; however, over three-quarters reflected a positive attitude. The provision of comprehensive palliative care, including pain control, symptom management, and psychosocial, economic, and spiritual support, was poor. Triangulation of the research Findings with literature review and expert opinion identified critical areas for implementation. These include need-based planning, training of multi-disciplinary palliative care providers and recipients, strengthening advocacy and partnership, generating evidence for decision-making, and integrating palliative care at all levels of the healthcare system. Conclusions: The knowledge and practice of comprehensive palliative care service delivery to patients with cervical cancer in Ethiopia were poor. This study has identified key areas for improvement to strengthen palliative care and improve the patients and their families quality of life.