Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

Agom, David A.; Allen, Stuart; Neill, Sarah; Sixsmith, Judith; Poole, Helen; Onyeka, Tonia C.; Ominyi, Jude

doi:10.1177/0825859719892084

Cited by 10 publications

(16 citation statements)

References 23 publications

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“…This is because when patients are retained for care, they continue to pay for the services they are receiving. Payment for health care services is the key financial mechanism operational in the Nigerian health care system (Agom et al, 2020;Aregbeshola & Khan, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…A hospital in south east Nigeria was purposively chosen for this study for reasons such as it rendered organized PC, which facilitated collection of useful data that revealed the complexities of culture being studied, proximity and accessibility which promoted prolonged engagement as well as immersion during field work. This government-owned hospital charges a fee for inpatient and outpatient cancer and PC services for individuals living in the south-eastern Nigeria and its surrounding states (Agom et al, 2020).…”

Section: Study Settingmentioning

confidence: 99%

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An Ethnographic Study of Palliative and End-of-Life Care in a Nigerian Hospital: Impact of Education on Care Provision and Utilization

et al. 2020

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Most clinicians receive little or no palliative care (PC) education. Similarly, patients and their families receive little or no information on PC. Our study explored education in PC, while examining for its impacts on service delivery and utilization from the perspective of health care professionals (HCPs), patients, and their families. An ethnographic approach was utilized to gather data from 41 participants. Spradley’s ethnographic analytical framework guided data analysis. Two themes identified were inadequate HCPs’ knowledge base and impact of service-users’ inadequate health education. The findings show that most HCPs had no formal education in PC, attributed to the lack of PC residency programs and the absence of educational institutions that provide such education. Patients and families also conveyed poor understandings of their illness and palliation, rooted in the HCP culture of partial disclosure of information about their diagnosis, care, and prognosis. Findings suggest a cultural shift that supports PC education for professionals is required to promote realist medical approach in the care for patients with life-limiting illnesses.

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Section: Discussionmentioning

confidence: 99%

Section: Study Settingmentioning

confidence: 99%

An Ethnographic Study of Palliative and End-of-Life Care in a Nigerian Hospital: Impact of Education on Care Provision and Utilization

et al. 2020

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“…In Nigeria, research has shown that most of the patients with cancer have no financial ability to pay for their services,[ 30 ] indicating that these patients may not access the services that could improve the quality of their life. In an effort to reduce the financial distress experienced by the patients, the palliative and oncology professionals provided them with financial assistance because there is no financial assistance scheme for this vulnerable group in Nigeria.…”

Section: Discussionmentioning

confidence: 99%

Exploring organizational culture regarding provision and utilization of palliative care in a Nigerian context: An interpretive descriptive study

Agom

Ominyi

Onyeka

et al. 2020

Indian J Palliat Care

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Background: Palliative care (PC) continues to be underutilized in Nigeria, but there is a lack of studies that explore organizational cultural dynamics regarding PC in Nigeria. The study aimed to understand the organizational culture in order to identify organizational enablers and inhibitors of the provision and utilization of PC in a Nigerian context. Methods: Identification of the organizational culture was developed using a qualitative interpretive descriptive design. Cultural enablers and inhibitors were mapped out using semi-structured interviews with 38 participants, consisting of medical staff, patients, and their relatives. Thematic analysis was used to identify and analyze patterns within the collected data. Results: Three themes were identified: cross-departmental collaborative practice, financial support practice, and continuity of care. The findings suggest that fundamental cultural changes, such as a policy for intradepartmental referral practices, telemedicine, and a welfare support system, are typically required as remedies for the failure to use PC in Nigeria and other similar contexts. Conclusions: This study offered a new understanding that not revealing deeper shared assumptions, and a shared way of thinking that underpins the PC practice within an organization, will have a negative bearing on organizational PC outcomes.

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“…25 Given its potential for yielding the understanding of complex processes as they occur in their natural setting, qualitative case studies are being increasingly used in a wide range of health-related disciplines and fields, including medicine, nursing, and health management. 26–28 The case study method is characterized by the use of multiple sources of evidence (eg, fieldwork, semi-structured interviews, documents). As argued by Yin, case study research is an empirical investigation that examines a contemporary phenomenon within its real-life context.…”

Section: Methodsmentioning

confidence: 99%

Control and Prevention of the COVID-19 Epidemic in China: A Qualitative Community Case Study

Zhang

Linzi

et al. 2021

RMHP

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Background Cross-infection among residents in communities is one of the most critical reasons for the rapid spread of the COVID-19 epidemic. The COVID-19 epidemic has been well controlled within Chinese communities, which has made important contributions to the country’s fight against it. Methods In this study, a qualitative case study design, with mixed methods applied to data collection and analysis, was employed to explore epidemic prevention measures taken by a Chinese community, namely Mulin, during the pandemic. Results The Mulin community established an integrated plan for epidemic prevention, including the prevention of the invasion of COVID-19, the prevention of cross-infection within the community, gaining the residents’ trust and support, and providing the residents with convenient services. Conclusion In the present work, the Mulin community was taken as a typical case study, and qualitative methods were employed to comprehensively summarize the practice and experience of the community’s epidemic prevention. Mulin’s practices could shed light on how communities in other countries, especially developing countries with large populations, can prevent the spread of COVID-19.

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Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

Cited by 10 publications

References 23 publications

An Ethnographic Study of Palliative and End-of-Life Care in a Nigerian Hospital: Impact of Education on Care Provision and Utilization

An Ethnographic Study of Palliative and End-of-Life Care in a Nigerian Hospital: Impact of Education on Care Provision and Utilization

Exploring organizational culture regarding provision and utilization of palliative care in a Nigerian context: An interpretive descriptive study

Control and Prevention of the COVID-19 Epidemic in China: A Qualitative Community Case Study

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