Developing Pathways Towards Improving End of Life Care and Advanced Planning

Mallia, Pierre

doi:10.1007/978-3-030-86386-9_14

Cited by 1 publication

(2 citation statements)

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“…Malawi is one of only two African countries with advanced levels of access to palliative care. 5 Adaptation of this intervention in other settings could be hampered by a lack of local skilled teachers and mentors. Nonetheless, data relating to suitable interventions to support person-centred care of older people in these settings are very limited, 19 , 20 and this study goes some way to inform this critical gap.…”

Section: Discussionmentioning

confidence: 99%

“…Only 12% of the 20 million people each year who require palliative care actually receive it, and while most provision is in high-income countries, 80% of need is in low- and middle-income countries. 5 Although palliative care and pain relief are global human rights within existing covenants, 6 palliative care is a neglected field in global health 7 with woefully inadequate coverage. Strengthening primary health care is vital to improve outcomes and reduce inequity as all cadres assist in the provision of holistic person-centred care.…”

Section: Introductionmentioning

confidence: 99%

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Improving person-centred care for older persons with serious multimorbidity in LMICs

Kwaitana,

van Breevoort,

Mnenula

et al. 2024

African Journal of Primary Health Care & Family Medicine

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Background: Few interventions are documented to meet person-centred needs of older people with serious multimorbidity in low- and middle-income countries where access to palliative care is limited. Most of the care in these settings is delivered by primary care health workers.Aim: This study reports the development and acceptability testing of a communication skills training and mentorship intervention for primary health care workers in Malawi.Setting: This study was conducted at Mangochi District Hospital in the south-eastern region of Malawi.Methods: Twelve primary health care workers (four clinical officers and eight nurses) working in the primary care clinics received the intervention. The intervention was designed using modified nominal group technique, informed by stakeholder interviews and a theory of change workshop. Acceptability is reported from thematic analysis of a focus group discussion with primary health care workers who received the intervention using NVivo version 14.Results: Older persons with serious multi-morbidity and their caregivers identified a need for enhanced communication with their healthcare providers. This helped to inform the development of a communication training skills and mentorship intervention package based on the local best practice six-step Ask-Ask-Tell-Ask-Ask-Plan framework. Primary health care workers reported that the intervention supported person-centred communication and improved the quality of holistic assessments, although space, workload and availability of medication limited the implementation of person-centred communication.Conclusion: The Ask-Ask-Tell-Ask-Ask-Plan framework, supported person-centered communication and improved the quality of holistic assessment.Contribution: This intervention offers an affordable, local model for integrating person-centered palliative care in resource-limited primary healthcare settings.

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Section: Discussionmentioning

confidence: 99%