Palliative care in Mozambique: Physicians’ knowledge, attitudes and practices

Pinto, Emilia; Marcos, Gustavo; Walters, Camila B; Gonçalves, Ferraz; Sacarlal, Jahit; Castro, Luísa; Rêgo, Guilhermina

doi:10.1371/journal.pone.0238023

Cited by 13 publications

(24 citation statements)

References 21 publications

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“…Each of the reviewed papers focused on different population groups: doctors, nurses, and mothers, 12 medical students, 13,14 junior and senior doctors, 15 and senior clinicians 16 . Other sets of population include private medical practitioners, 17 physicians, 18 psychiatrists, 19 aged adults 20 and adults 21 . Some papers include other population groups containing the Xhosa ethnic group of South Africa, 22 lay people and health professionals, 23 all patients had life support, 24 oncologists, and registered nurses 25 .…”

Section: Resultsmentioning

confidence: 99%

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Euthanasia in Africa: A scoping review of empirical evidence

Amzat

Kanmodi

Ismail

et al. 2023

Health Science Reports

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Background and Aims The core ethical perplexity is that physician‐assisted suicide and euthanasia (PAS/E) contradicts the core value of medical practice which is about the duty of care to preserve life. While most arguments for and against euthanasia emerge from other continents, no African country legalizes or decriminalizes PAS/E. The essence of this scoping review is to collate evidence and scientific voices on euthanasia in Africa by synthesizing empirical articles on the subject in Africa. Methods In this scoping review, a systematic search of five electronic research databases—PubMed, SCOPUS, CINHAL Complete, Allied and Complementary Medicine (AMED), and APA PsycInfo—was conducted to identify relevant articles conducted in Africa on euthanasia. After deduplication with the Rayyan software, the retrieved literature were screened for eligibility, and only eligible articles were included in the review. Relevant data from these articles were extracted and analyzed using narrative synthesis. Results Only 14 articles reporting empirical studies, conducted in Africa, and published in English, were included in the review after a rigorous screening process. The review shows a wide rejection of euthanasia, but there is not much resistance to passive euthanasia, that is, withholding/withdrawing life‐saving medical care from a terminally ill patient, mostly due to advanced age of the patient and the incurability of the illness. Many factors, such as religion, profession, and age help in shaping the way an individual view and understand PAS/E. Professionals take the patient's clinical condition and sociocultural context into consideration when making decisions about end‐of‐life care. The sociocultural context did not favor PAS/E. Conclusion Euthanasia will continue to be a subject of controversy and debate in Africa and elsewhere. The majority of Africans hold the duty of care and preservation of life as the hallmark of medical practice, which informs the wide rejection of PAS/E.

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Section: Resultsmentioning

confidence: 99%

“…The review noted that some medical professionals would rather inform the patient's family members of the prognosis. This will allow the patient's family to comfort him or her before the disclosure of any medical information 18 . Then the patient would be left with the option of deciding on the preferred treatment or course of action.…”

Section: Resultsmentioning

confidence: 99%

Euthanasia in Africa: A scoping review of empirical evidence

Amzat

Kanmodi

Ismail

et al. 2023

Health Science Reports

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“…Respondents specified that they prefer to utilize PC to continue care when no other therapy options remain, yet many also agree that early referral is beneficial for patients. Previous surveys have shown that oncology providers largely agree that cancer patients should receive PC early in the disease course, but actual referral practices often fall short of this goal [ 14 , 23 ]. This discrepancy may be due to the limited availability of PC services and decisions to reserve PC resources for patients at advanced stages of disease who may be most in need.…”

Section: Discussionmentioning

confidence: 99%

The perspectives of oncology healthcare providers on the role of palliative care in a comprehensive cancer center

et al. 2022

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Background Palliative care (PC) is an essential part of oncologic care, but its optimal role within a cancer center remains unclear. This study examines oncology healthcare providers’ perspectives about the role of PC at a comprehensive cancer center (CCC). Methods Physicians, nurses, and other oncology healthcare providers at a CCC were surveyed for their opinions about the role of inpatient and outpatient PC, preferences for PC services, and barriers to referral. Chi-squared tests and multiple regression analyses were performed to explore associations. Results We received 137/221 completed questionnaires (61% response rate). Respondents were generally female (78%), had ≤ 10 years of service (69%), and included physicians (32%), nurses (32%), and advanced practice providers (17%). Most respondents (82%) agreed that more patients could benefit from PC. They also agreed that PC is beneficial for both outpatient and inpatient management of complex pain (96 and 88%), complex symptoms (84 and 74%), and advanced cancer patients (80 and 64%). Transition to hospice (64 vs. 42%, p = 0.007) and goals of care (62 vs. 49%, p = 0.011) provided by PC services were more valued by respondents for the inpatient than for the outpatient setting. Barriers to utilizing PC included lack of availability, unsure of when to refer, and poor communication. The majority of respondents (83%) preferred a cancer focused PC team to provide high-quality care. Conclusions Overall, the majority of oncology health care providers believe that more patients could benefit from PC, but opinions vary regarding the roles of inpatient and outpatient PC. Barriers and areas for improvement include availability, referral process, and improved communication.

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“…[ 2 ] Palliative care is one of the care types in the clinical setting. [ 3 ] It is a basic human right for all patients, especially those requiring constant care due to chronic, progressive and excruciating pains caused by chronic malignant and non-malignant diseases. [ 4 ] Palliative care is comprehensive and holistic care provided to patients by an interdisciplinary team of physicians, health-care providers, nurses, psychologists and social workers during hospitalisation and even after discharge.…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Psychometric Properties of the ‘Patients’ Perspective of the Quality of Palliative Care Scale’

Kolagari

Khoddam

Guirimand³

et al. 2022

IJPC

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Objectives: Palliative care is a basic human right for all patients suffering from progressive and excruciating pain, limitations in daily activities as well as requiring constant care. The development of palliative care is always associated with the physical, psychological, social and spiritual care quality level and requires continuous evaluation by the care-receiving patients. This study aimed to determine the psychometric properties of the patients’ perspective of the quality of palliative care scale. Materials and Methods: This methodological study was conducted on 500 patients with chronic diseases admitted to the hospitals affiliated in Golestan University of Medical Sciences, between 2019 and 2020. Participants were selected through stratified sampling through proportional allocation as well as considering the bed occupancy rate in the two referral hospitals of the university. According to Wild approach, we translated the original version of the scale the patients’ perspectives of the quality of the palliative care scale with 35 items and eight subscales. Using exploratory and confirmatory factor analysis, the psychometric properties of the scale (i.e., initial reliability and face, content, convergent and construct validities) were assessed. The reliability of the scale was calculated by applying Cronbach’s alpha coefficient, McDonald’s omega coefficient and the Intraclass correlation coefficient (ICC). SPSS-16 and AMOS-24 software programs were used to analyse the data. Results: Three items were omitted after assessing the initial reliability of the translated version of the perspectives of the quality of the palliative care scale using adjusted Cronbach’s alpha. The qualitative face validity and impact score of the remaining items of the scale were confirmed by the target group. Meanwhile, a panel of experts confirmed the content validity ratio and content validity index. Convergent validity was approved by calculating the average variance extracted >0.5. Performing EFA led to the extraction of 7 subscales with 32 items. CFA and goodness of fit indices such as GFI = 0.98, CFI = 0.91, RMSEA = 0.048 and GFI = 0.97 confirmed the construct model by omitting three items. Hence, the Persian version of the patient’s perspective of the quality of palliative care scale was finalised, including seven subscales with 29 items. ICC of >0.7 represented good reliability. Moreover, Cronbach’s alpha and McDonald’s omega coefficient confirmed the internal consistency of the scale. Conclusion: Based on the findings of this study, the Persian version of the patients’ perspective of the quality of palliative care scale is introduced as a valid and reliable scale. It can accurately indicate and predict the meticulous quality of such care in hospitalised patients and can be used in the cure and care assessments in the health system.

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Palliative care in Mozambique: Physicians’ knowledge, attitudes and practices

Cited by 13 publications

References 21 publications

Euthanasia in Africa: A scoping review of empirical evidence

Euthanasia in Africa: A scoping review of empirical evidence

The perspectives of oncology healthcare providers on the role of palliative care in a comprehensive cancer center

Psychometric Properties of the ‘Patients’ Perspective of the Quality of Palliative Care Scale’

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