COVID-19 and palliative medicine: faith-based hospitals in India

Abstract

ObjectivesFaith-based organisations (FBOs) in India provide health services particularly to marginalised communities. We studied their preparedness and delivery of palliative care during COVID-19 as part of a mixed-method study. We present the results of an online questionnaire.MethodsAll FBOs providing palliative care in India were invited to complete an online questionnaire. Descriptive analysis was undertaken.ResultsResponse rate was 46/64 (72%); 44 provided palliative care; 30/44 (68%) were in rural or semiurban areas with 10–2700 beds. Fifty-two per cent (23/44) had dedicated palliative care teams and 30/44 (68%) provided it as part of general services; 17/44 (39%) provided both. 29/44 (66%) provided palliative care for cancer patients; 17/44 (34%) reported that this was more than half their workload.The pandemic led to reduced clinical work: hospital 36/44 (82%) and community 40/44 (91%); with reduction in hospital income for 41/44 (93%). 18/44 (44%) were designated government COVID-19 centres; 11/40 (32%) had admitted between 1 and 2230 COVID-19 patients.COVID-19 brought challenges: 14/44 (32%) lacked personal protective equipment; 21/44 (48%) had reduced hospital supplies and 19/44 (43%) lacked key medications including morphine. 29/44 (66%) reported reduction in palliative care work; 7/44 (16%) had stopped altogether. Twenty-three per cent (10/44) reported redeployment of palliative care teams to other work. For those providing, palliative care 32/37 (86%) was principally for non-COVID patients; 13/37 (35%) cared for COVID-19 patients. Service adaptations included: teleconsultation, triaged home visits, medication delivery at home and food supply.ConclusionsFBOs in India providing palliative care had continued to do so despite multiple challenges. Services were adapted to enable ongoing patient care. Further research is exploring the effects of COVID-19 in greater depth.

Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review

“…Perhaps the most significant change in this domain was the new – or enhanced – utilization of telehealth-supported clinical encounters (phone- or video-based) and electronic patient portals [ 8 ▪ , 9 ▪ , 11 ▪▪ , 14 , 15 , 16 ▪ – 19 ▪ ]. These interventions were critical in bridging care delivery gaps imposed by COVID-19 mitigation (e.g., social distancing, visitor restrictions).…”

“…However, more rigorous testing is needed. Meaningful lines of inquiry moving forward include evaluating algorithms to identify which patients would benefit from telehealth, examining technological literacy, assessing the quality of communication in telehealth encounters, testing telehealth encounter efficacy in varied contexts (e.g., cultural or clinical), and investigating patient/caregiver perceived quality of care experience [ 9 ▪ , 10 ▪▪ , 11 ▪▪ , 14 , 48 – 50 ].…”

Palliative care delivery in India during COVID-19 pandemic: role of faith-based hospitals – a qualitative study

“…Forty-four FBHs offering PC services from a database held by Emmanuel Hospitals Association (EHA) and the Christian Medical Association of India in September 2020 had completed the initial survey. 5 Of them, 32 HCPs had indicated willingness to be interviewed, 10 participants were recruited through purposive sampling to complete a semistructured interview over Zoom. They were approached via email and informed consent was obtained.…”

“…There was reduction of PC work in 66% and in 16% it had stopped altogether for a certain period. 5 Interview participants for this study were recruited from a sample of the surveyed FBHs, to further explore the impact of the COVID-19 pandemic on patients with PC needs and their families, challenges faced by PC services in FBHs and the solutions adopted by them and how these good practices can strengthen future PC delivery. The results of our study will contribute towards learning on effective provision of care for vulnerable patients during pandemics and other crisis situations especially in LMICs.…”