The Contribution of Healthcare Workers’ Knowledge on Use of Integrated Palliative Care Approach in the Management of Chronic and Life Threatening Diseases at Kakamega County Referral Hospital, Kenya

Abstract

Integrated Palliative care approach (IPCA) is an approach that aims to improve the quality of life of people and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering. However, the use of IPCA in Kenya is low due to lack of access to medicines, technologies and infrastructure. The main objective was to investigate the use of IPCA in the management of chronic diseases at Kakamega County Referral Hospital (KCRH). The study design was a descriptive cross sectional with the quantitative approach. A questionnaire was administered to participants and the data analysis using SPSS. P-value was set at < 0.05. Of the total 196 Health Community Workers (HCWs) selected, a response rate of 95 % (186/196) was register. It showed that 50% males were less likely to have used IPCA as compared to their female counterparts (OR=0.5, 95% CI: 0.3-0.9) and 90% nurses were less likely to practice IPCA as compared to RCOs and MOs (OR=0.1, 95%CI: 0.1-0.5). The overall hypothesis test on the association between knowledge and performance was not significant (OR=1.6; 95% CI: 0.7-3.6, P<.2). The best managed symptoms by majority of respondents were severe diarrhea, anxiety and depression while the poorly managed areas were pain assessment and treatment of dyspnea. In conclusion, the HCWs were knowledgeable about IPCA but few utilized IPCA in managing terminal illnesses. Therefore, is a need to improve the HCWs' skills and performance, increase funding, and improve infrastructure and coordination of use of IPCA.