Health Care Providers' Attitudes and Beliefs on Providing Palliative Care to Patients in Bahrain: Findings From a Qualitative Study

Weng, Xingran; Nakdali, Rama; Almoosawi, Barrak; Saeed, Mahmood Al; Maiser, Samuel; Banna, Mona Al

doi:10.1016/j.jpainsymman.2020.11.006

Cited by 3 publications

(4 citation statements)

References 24 publications

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“…This finding is consistent with those from a study of clinicians in Bahrain who perceived PC as synonymous with end-of-life or hospice care. 42 Clinicians in this study also reported challenges initiating end-of-life discussions because family members typically oppose disclosure of terminal diagnoses to patients. 42 In Al-Awamer and Downar's study of barriers to implementation of PC in the Middle East, they also identified unfamiliarity with the role and benefits of PC and cultural barriers as challenges.…”

Section: Discussionmentioning

confidence: 87%

“…42 Clinicians in this study also reported challenges initiating end-of-life discussions because family members typically oppose disclosure of terminal diagnoses to patients. 42 In Al-Awamer and Downar’s study of barriers to implementation of PC in the Middle East, they also identified unfamiliarity with the role and benefits of PC and cultural barriers as challenges. 43 Given the importance of understanding and addressing cultural aspects of end-of-life in PC, the cultural and linguistic barriers the large non-Muslim nursing workforce in Arabia faces may pose additional challenges.…”

Section: Discussionmentioning

confidence: 87%

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Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review

Almulla

Hassouneh

2022

Home Health Care Management & Practice

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Aging populations and a rising disease burden have increased the need for palliative care (PC). Despite the growing demand for PC, only 14% of patients worldwide receive this service. Home-based PC is necessary because many people prefer to receive care and die at home. Nurses are well equipped to address diverse health care needs in the community and are critical to successful delivery of home-based PC. The purpose of this review is to synthesize and analyze literature relevant to home-based PC in Saudi Arabia with an emphasis on nursing. This purpose required us to examine literature in two areas: PC and home health care (HHC). We identified studies through database searches. We found 24 studies published between 2005 and 2021 that met quality and inclusion criteria. Although PC and HHC are associated with positive outcomes, lack of nurses’ knowledge and awareness of PC and the underdevelopment of HHC in Saudi Arabia have contributed to underuse of these services. Nurses are vital to the functioning of interdisciplinary teams and effective interfacing with patients, caregivers, and families. Education and training of nurses in Saudi Arabia is essential to promoting access to PC and HHC and the development of home-based PC in the kingdom.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 87%

Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review

Almulla

Hassouneh

2022

Home Health Care Management & Practice

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“…Although no studies have examined ethical and legal aspects of nursing care in SA, a quantitative study of medical interns and residents in SA found a lack of familiarity with policies related to legal aspects of PC, such as policies outlined in do not resuscitate documents (Amoudi et al, 2016). Similarly, physicians and nurses in Bahrain have reported feeling conflicted about the extent to which treatment should be given during end-of-life, a problem worsened by limited hospital guidelines (Weng et al, 2021). Not considering patients' wishes and quality of life during end-of-life creates further challenges and ethical dilemmas for healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia

Almulla,

Dieckmann,

Najjar

et al. 2024

Home Healthcare Now

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Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

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“…A study conducted recently by Weng et al in the same institute looked at health care providers' attitudes and beliefs on providing palliative care to patients in Bahrain. 30 Most health care providers highlight the need for end-of-life care and palliative care policies with barriers to the development of those policies being culture, health care law and policy, conservative interpretations of Islam, and a lack of professional expertise. When it comes to prioritizing who would benefit from ICU admission and who would not, The APACHE II score could be superior to the Katz functional Index and Charlson's Comorbidity Index.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of mechanically ventilated elderly patients in the absence of an end-of-life care policy: a retrospective study from Bahrain

et al. 2021

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BACKGROUND: Globally, the percentage of elderly patients has been increasing, leading to a higher demand for healthcare resources and intensive care. Bahrain has a majority Muslim population and Islam governs most policies, including end-of-life care. All patients at our institute receive full resuscitative measures regardless of the prognosis, leading to a high number of mechanically ventilated patients. OBJECTIVES: Assess characteristics, outcomes, theoretical costs, and use of antibiotics in critically ill elderly patients requiring mechanical ventilation. DESIGN: Retrospective. SETTING: Intensive care unit and general ward of a tertiary medical care center. PATIENTS AND METHODS: We studied all elderly patients (≥60 years old) admitted under general medicine in the period of January to June 2018 who needed intensive care and were intubated. MAIN OUTCOME MEASURES: The duration of mechanical ventilation, theoretical costs, antibiotic usage. SAMPLE SIZE: 140 patients. RESULTS: Of 140 patients, 136 died (97%) and half of the deaths (n=69, 50.7%) occurred within the first 24 hours of intubation. Sixty-nine (79.3%) of the patients on short-term ventilation (≤96 hours) died within 24 hours of intubation, while the four survivors were on long-term ventilation (>96 hours) ( P <.001). All the nonsurviving patients (n=136) were on antimicrobial therapy, mostly for hospital-acquired infections. The median (interquartile range) APACHE II score was relatively high at 28.0 (8.0) with significantly higher scores in the early mortality group compared to the late mortality group (30 [10] vs 26 [7], P =.013) and higher scores in the short-term vs long-term ventilation group (29 [10] vs 26 [7], P =.029). The median theoretical cost per patient in the early and late mortality groups was USD 10 731 and USD 30 660, respectively ( P <.001). CONCLUSIONS: Given that less than 3% of patients had a favorable outcome, 50% of the cases died within 24 hours after intubation, hospital costs and antimicrobial use were high, the current policy of “full resuscitative measures for all” should be revised. We suggest implementing an end-of-life care policy, since the goal of resuscitation is to reverse premature death, not prolong the dying process. LIMITATIONS: Small sample size and absence of long-term follow-up. Theoretical costs were used as no direct calculated costs were available in our hospital. CONFLICT OF INTEREST: None

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Health Care Providers' Attitudes and Beliefs on Providing Palliative Care to Patients in Bahrain: Findings From a Qualitative Study

Cited by 3 publications

References 24 publications

Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review

Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review

Palliative Care Practices and Knowledge of Home Care Nurses in Saudi Arabia

Characteristics and outcomes of mechanically ventilated elderly patients in the absence of an end-of-life care policy: a retrospective study from Bahrain

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