Nurse‐led adult palliative care models in low‐ and middle‐income countries: A scoping review

Abstract

AimsTo map evidence on the nature and extent of use of nurse‐led palliative care models in low‐ and middle‐income countries serving adults with life‐limiting conditions.DesignA scoping review of the literature was undertaken.Data SourcesA systematic search was performed from database inception to March 2022 in: Medline, EMBASE, CINAHL, Wiley Cochrane Library, SCOPUS, Web of Science, SciELO and Global Health. Main search terms included: Nurse‐led AND Palliative care AND Low‐and middle‐income countries. Grey literature was searched from Proquest Dissertations and Theses Global, the World Health Organization and selected palliative care websites. We searched the reference list of included articles for additional studies.Review MethodsWe used the framework by Arksey and O'Malley and the PRISMA‐ScR guidelines. Titles and abstracts were screened by one reviewer and full text by two reviewers. Thematic analysis was used to synthesize data and results are presented descriptively using themes and categories.ResultsEighteen studies were included, with majority from Sub‐Saharan Africa (10/20). Three nurse‐led palliative care models emerged: nurse‐led empowering care, nurse‐led symptom control and nurse‐led multicomponent palliative care. They served particularly cancer and HIV patients and were delivered in person or by telehealth care. Reported outcomes were adherence to therapy, improved self‐care ability, improved quality of life and increased access to palliative.ConclusionsThe use of nurse‐led palliative care in low‐ and middle‐income countries is in its developing stages and seems feasible. Nursing roles in in low‐ and middle‐income countries need to be expanded by developing advanced practice nurses and nurse practitioner programmes, with palliative care content. More impact evaluation studies on the use of nurse‐led palliative care models in these countries are needed.ImpactThis review highlights nurse‐led care models that can enhance access and quality of life of patients with life‐limiting conditions in low‐ and middle‐income countries.

Understudied phenomena and emerging methodologies in nursing and midwifery: What's new on the horizon?

“…They highlighted that nurse-led care models can improve the quality of life of patients with life-limiting illnesses and improve access to services in low-and middle-income countries (Bassah et al, 2023).…”

“…While the crucial role of nurses in healthcare is well‐acknowledged, there are several underexplored areas of nursing practice that are examined in this special issue. For example, the experiences of disabled nurses (Baker et al, 2023), nurse‐led models of care (Bassah et al, 2023), and the impact of varying interferences on nurses' working memory (Hu et al, 2023). In a scoping review, Baker et al (2023) identified the varying workplace experiences of nurses and midwives with disabilities.…”

“…They illuminated that nurses and midwives can be greatly affected by disability and highlighted the importance of diversity, equity, accessibility and inclusion across the profession (Baker et al, 2023). A scoping review by Bassah et al (2023) mapped evidence in low‐ and middle‐income countries in relation to the use of nurse‐led palliative care models for adults with life‐limiting illnesses. They highlighted that nurse‐led care models can improve the quality of life of patients with life‐limiting illnesses and improve access to services in low‐ and middle‐income countries (Bassah et al, 2023).…”

“…A scoping review by Bassah et al (2023) mapped evidence in low‐ and middle‐income countries in relation to the use of nurse‐led palliative care models for adults with life‐limiting illnesses. They highlighted that nurse‐led care models can improve the quality of life of patients with life‐limiting illnesses and improve access to services in low‐ and middle‐income countries (Bassah et al, 2023). Using a repeated measures design, Hu et al (2023) explored the role of attention control and the impact varying types of interference had on nurses' working memory.…”

Comparison of palliative care education for family caregivers in high-and-low-income countries: An integrative review

“…In palliative care, nurses’ roles are mostly assessed on how they care for patients, support family caregivers, and meet professional requirements (Soikkeli Jalonen et al, 2020 ). Although the evidence is still limited, a previous study showed that nurses-led interventions in palliative care in Low- and Middle-Income Countries (LMICs) appear promising and feasible to be conducted (Bassah et al, 2023 ).…”