Rasheed Ofosu-Poku, Michael Owusu-Ansah, John Antwi
{"title":"非恶性慢性病患者转诊到专科姑息治疗:加纳一家教学医院的研究","authors":"Rasheed Ofosu-Poku, Michael Owusu-Ansah, John Antwi","doi":"10.1155/2020/8432956","DOIUrl":null,"url":null,"abstract":"<p><p>Ghana's chronic disease burden is on the rise. An essential aspect of clinical care in chronic disease management is to improve the quality of life of both patients and their families and to help them cope with the experience of life-limiting illness. Specialist palliative care services help reach this objective, especially in the context of complex psychosocial challenges and high symptom burden. It is, therefore, necessary that as many patients as possible get access to available specialist palliative care services. This paper explores the factors influencing referral of patients with nonmalignant chronic diseases for specialist palliative care. A qualitative approach was used to explore these factors from eight (8) participants-four (4) physician specialists and four (4) next of kin of patients with advanced nonmalignant chronic illness. Individual face-to-face interviews were conducted using a semistructured interview guide. Interviews were audio-recorded and data coded, themes and subthemes were identified, and thematic analysis was done. Barriers and motivators identified were categorized as either related to physicians, institution, or family. Barriers to referral were perception of the scope of palliative care, medical paternalism, lack of an institutional referral policy, poor human resource capacity of the palliative care team, and lack of awareness about the existence of specialist palliative care service. Poor economic status of the patient and family, poor prognosis, previous interaction with the palliative care team, and an appreciation of patients' expectations of the healthcare system were identified as motivators for referral. The palliative care team must therefore increase awareness among other health professionals about their services and facilitate the development and availability of a clear policy to guide and improve referrals.</p>","PeriodicalId":13831,"journal":{"name":"International Journal of Chronic Diseases","volume":"2020 ","pages":"8432956"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/8432956","citationCount":"13","resultStr":"{\"title\":\"Referral of Patients with Nonmalignant Chronic Diseases to Specialist Palliative Care: A Study in a Teaching Hospital in Ghana.\",\"authors\":\"Rasheed Ofosu-Poku, Michael Owusu-Ansah, John Antwi\",\"doi\":\"10.1155/2020/8432956\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Ghana's chronic disease burden is on the rise. An essential aspect of clinical care in chronic disease management is to improve the quality of life of both patients and their families and to help them cope with the experience of life-limiting illness. Specialist palliative care services help reach this objective, especially in the context of complex psychosocial challenges and high symptom burden. It is, therefore, necessary that as many patients as possible get access to available specialist palliative care services. This paper explores the factors influencing referral of patients with nonmalignant chronic diseases for specialist palliative care. A qualitative approach was used to explore these factors from eight (8) participants-four (4) physician specialists and four (4) next of kin of patients with advanced nonmalignant chronic illness. Individual face-to-face interviews were conducted using a semistructured interview guide. Interviews were audio-recorded and data coded, themes and subthemes were identified, and thematic analysis was done. Barriers and motivators identified were categorized as either related to physicians, institution, or family. Barriers to referral were perception of the scope of palliative care, medical paternalism, lack of an institutional referral policy, poor human resource capacity of the palliative care team, and lack of awareness about the existence of specialist palliative care service. Poor economic status of the patient and family, poor prognosis, previous interaction with the palliative care team, and an appreciation of patients' expectations of the healthcare system were identified as motivators for referral. The palliative care team must therefore increase awareness among other health professionals about their services and facilitate the development and availability of a clear policy to guide and improve referrals.</p>\",\"PeriodicalId\":13831,\"journal\":{\"name\":\"International Journal of Chronic Diseases\",\"volume\":\"2020 \",\"pages\":\"8432956\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-03-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1155/2020/8432956\",\"citationCount\":\"13\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Chronic Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2020/8432956\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Chronic Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/8432956","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Referral of Patients with Nonmalignant Chronic Diseases to Specialist Palliative Care: A Study in a Teaching Hospital in Ghana.
Ghana's chronic disease burden is on the rise. An essential aspect of clinical care in chronic disease management is to improve the quality of life of both patients and their families and to help them cope with the experience of life-limiting illness. Specialist palliative care services help reach this objective, especially in the context of complex psychosocial challenges and high symptom burden. It is, therefore, necessary that as many patients as possible get access to available specialist palliative care services. This paper explores the factors influencing referral of patients with nonmalignant chronic diseases for specialist palliative care. A qualitative approach was used to explore these factors from eight (8) participants-four (4) physician specialists and four (4) next of kin of patients with advanced nonmalignant chronic illness. Individual face-to-face interviews were conducted using a semistructured interview guide. Interviews were audio-recorded and data coded, themes and subthemes were identified, and thematic analysis was done. Barriers and motivators identified were categorized as either related to physicians, institution, or family. Barriers to referral were perception of the scope of palliative care, medical paternalism, lack of an institutional referral policy, poor human resource capacity of the palliative care team, and lack of awareness about the existence of specialist palliative care service. Poor economic status of the patient and family, poor prognosis, previous interaction with the palliative care team, and an appreciation of patients' expectations of the healthcare system were identified as motivators for referral. The palliative care team must therefore increase awareness among other health professionals about their services and facilitate the development and availability of a clear policy to guide and improve referrals.