Palliative Care Needs among Patients with Advanced Illnesses in Bhutan

Abstract

Background Palliative care improves the quality of lives of patients and families affected by life-limiting illnesses through the prevention and relief of suffering. While palliative care is well established in developed countries, it is inadequate or non-existent in most developing countries. Palliative care is an emerging concept in Bhutan, a tiny Himalayan Kingdom. A small community palliative care service is available in the national referral hospital with three dedicated inpatient palliative care beds. This study explored the needs for palliative care among patients diagnosed with advanced illnesses and is a component of a larger project aimed to inform a suitable palliative care model for the country.Methods This is a cross-sectional descriptive study. A survey, using a structured questionnaire including the EORTC QLQ-C30, was carried out among patients with advanced illness in hospitals, primary care units and communities across the country. Purposeful and snowball sampling strategies were used to recruit study participants.Results Seventy (76%), out of 93 eligible patients, agreed to participate in the survey. Participants reported low to moderate scores on physical, role, emotional, cognitive and social functioning, a moderate score for the global health/ quality of life scale and moderately high (worse) scores in symptoms including fatigue, pain, insomnia, loss of appetite and the financial impact from the disease.Conclusions The symptom burden experienced by patients affected by terminal and advanced illnesses demonstrates the need for palliative care in Bhutan. These findings will help inform the development of a public health-focused palliative care model, modified to the Bhutanese context, as recommended by the World Health Organization.

Nivel de Conocimiento Sobre Cuidados Paliativos del Personal de Enfermería en un Hospital de Segundo Nivel

“…Se reconoce la aplicación de cuidados paliativos como un derecho fundamental del ser humano, haciendo obligatorio su desarrollo en las instituciones de salud en donde se manejen pacientes con padecimientos terminales, ya que sus beneficios impactan de manera positiva al paciente y su familia, mediante el desarrollo de cuidados físicos, psicológicos, sociales, emocionales y espirituales durante el transcurso de la enfermedad (Laabar et al, 2021). La falta de formación y de concientización con respecto a estos por parte de los profesionales de la salud es un obstáculo importante a los programas de mejoramiento del acceso a esos cuidados (Covarrubias-Gómez et al, 2019).…”