Palliative care education and training in Liberia: A qualitative exploration of current state and challenges to further development
PDF

Keywords

palliative care
curriculum
health personnel
nursing
Liberia

How to Cite

Stephens, M. T., & Rochmawati, E. (2022). Palliative care education and training in Liberia: A qualitative exploration of current state and challenges to further development. Belitung Nursing Journal, 8(5), 453–461. https://doi.org/10.33546/bnj.2237
Share |

Abstract

Background: Palliative care is an integral approach to enhancing patients’ overall quality of life by taking into account their entire lives and addressing any suffering they may be experiencing. Thus, palliative care education and training should be advanced. However, palliative care training and education in Liberia have just started, and their development warrants further investigation.

Objective: This research aimed to explore the state of palliative care education in Liberia and highlight its barriers and challenges.

Methods: A descriptive qualitative exploratory study design was adopted in this study. Semi-structured interviews were conducted with ten male lecturers and four female nurses to gain in‐depth insight into their perspectives on palliative care education. Thematic analysis with NVivo 12 plus was used for data analysis.

Results: Four themes emerged from the data: 1) the need for palliative education (lack of healthcare professionals, government support, regular workshops, integration, and interprofessional education on palliative care), 2) palliative care barriers (lack of curriculum implementation, lack of experience, lack of government actions, and poor infrastructures), 3) the level of student knowledge (senior and junior level, same educational level, and regular teaching materials), and 4) the roles of health care professionals (attention on palliative care, providing education on pain, and public awareness).

Conclusion: The study findings may serve as input to develop palliative care education and training in Liberia. The identified gaps must be filled, and critical barriers must be overcome if the area of palliative care needs to be advanced. However, the comprehensive knowledge gathered in this study can be used by nurses, lecturers, and multidisciplinary teams to achieve the effectiveness of palliative care for patients.

https://doi.org/10.33546/bnj.2237
PDF

Copyright

Copyright (c) 2022 Moses Tende Stephens, Erna Rochmawati

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Abstract views: 80 | PDF views: 56

Downloads

Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

There is no conflict of interest in this research.

Acknowledgment

The authors would like to thank the participants in this for their cooperation and support during data collection.

Authors’ Contributions

Both authors (MS, ER) participated sufficiently in the manuscript’s concept, design, analysis, writing, and critical revision. In addition, the first author (MS) conducted the interviews and collection.

Data Availability

Due to the nature of this research, participants of this study did not provide consent for their data to be shared publicly, so supporting data is not available.


References

Aldridge, M. D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., Centeno, C., & Meier, D. E. (2016). Education, implementation, and policy barriers to greater integration of palliative care: A literature review. Palliative Medicine, 30(3), 224-239. https://doi.org/10.1177/0269216315606645

Alele, D., Dahn, B., Camanor, S., Ikpi, E., Lieber, M., Dottino, A., Johnson, B., Gharoro, E. P., & Beddoe, A. M. (2020). Novel use of fine needle aspiration (FNA) biopsy to diagnose cervical cancer in a low‐resource setting: A case series Morovia, Liberia. Clinical Case Reports, 8(8), 1413-1418. https://doi.org/10.1002/ccr3.2911

Amery, J. M., Rose, C. J., Byarugaba, C., & Agupio, G. (2010). A study into the children's palliative care educational needs of health professionals in Uganda. Journal of Palliative Medicine, 13(2), 147-153. https://doi.org/10.1089/jpm.2009.0153

Anyanwu, E. C., & Agbedia, C. (2020). The practice of palliative care amongst nurses in selected hospitals in Eastern Nigeria. Open Journal of Nursing, 10(06), 100799. http://www.scirp.org/journal/Paperabs.aspx?PaperID=100799

Balicas, M. R. (2018). The effect of palliative care nursing education to improve knowledge in palliative care of hospital-based nurses caring for patients with chronic, serious illness. https://hsrc.himmelfarb.gwu.edu/son_dnp/33

Bassah, N., Seymour, J., & Cox, K. (2014). A modified systematic review of research evidence about education for pre-registration nurses in palliative care. BMC Palliative Care, 13(1), 1-10. https://doi.org/10.1186/1472-684X-13-56

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

Budukh, A. M., Chaudhary, D., Sancheti, S., Dora, T., Goel, A. K., Singla, A., Sali, A., Shinde, S., Chauhan, K. S., & Kadam, P. (2021). Determinants of completion of cancer directed treatment: An experience from a rural cancer centre, Sangrur, Punjab state, India. Ecancermedicalscience, 15, 1313. https://doi.org/10.3332%2Fecancer.2021.1313

Bush, T., & Shahwan-Akl, L. (2013). Palliative care education–does it influence future practice? Contemporary Nurse, 43(2), 172-177. https://doi.org/10.5172/conu.2013.43.2.172

Downing, J., Batuli, M., Kivumbi, G., Kabahweza, J., Grant, L., Murray, S. A., Namukwaya, E., & Leng, M. (2016). A palliative care link nurse programme in Mulago Hospital, Uganda: An evaluation using mixed methods. BMC Palliative Care, 15(1), 1-13. https://doi.org/10.1186/s12904-016-0115-6

Downing, J., Knapp, C., Muckaden, M. A., Fowler-Kerry, S., & Marston, J. (2015). Priorities for global research into children’s palliative care: Results of an International Delphi Study. BMC Palliative Care, 14(1), 1-10. https://doi.org/10.1186/s12904-015-0031-1

Downing, J., & Ling, J. (2012). Education in children's palliative care across Europe and internationally. International Journal of Palliative Nursing, 18(3), 115-120. https://doi.org/10.12968/ijpn.2012.18.3.115

Effendy, C., & Kristanti, M. S. (2021). The importance of providing palliative care for patients with severe COVID-19 in Indonesia. Belitung Nursing Journal, 7(5), 438-442. https://doi.org/10.33546/bnj.1466

Ens, C. D. L., Chochinov, H. M., Gwyther, E., Moses, S., Jackson, C., Thompson, G., & Harding, R. (2011). Postgraduate palliative care education: Evaluation of a South African programme. South African Medical Journal, 101(1), 42-44. https://doi.org/10.7196/samj.4171

Eriksson, G., Bergstedt, T. W., & Melin-Johansson, C. (2015). The need for palliative care education, support, and reflection among rural nurses and other staff: A quantitative study. Palliative & Supportive Care, 13(2), 265-274. https://doi.org/10.1017/S1478951513001272

Fraser, B. A., Powell, R. A., Mwangi-Powell, F. N., Namisango, E., Hannon, B., Zimmermann, C., & Rodin, G. (2017). Palliative care development in Africa: Lessons from Uganda and Kenya. Journal of Global Oncology, 4, 1-10. https://doi.org/10.1200/JGO.2017.010090

Frey, R., Gott, M., Raphael, D., O'Callaghan, A., Robinson, J., Boyd, M., Laking, G., Manson, L., & Snow, B. (2014). Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting. BMJ Supportive & Palliative Care, 4(4), 381-389. http://dx.doi.org/10.1136/bmjspcare-2012-000346

Fusch, P. I., & Ness, L. R. (2015). Are we there yet? Data saturation in qualitative research. Qualitative Report, 20(9), 1408-1416. https://doi.org/10.46743/2160-3715/2015.2281

Gage, C. H., Geduld, H., & Stassen, W. (2020). South African paramedic perspectives on prehospital palliative care. BMC Palliative Care, 19(1), 1-11. https://dx.doi.org/10.1186%2Fs12904-020-00663-5

Glass, M., Rana, S., Coghlan, R., Lerner, Z. I., Harrison, J. D., Stoltenberg, M., Namukwaya, E., & Humphreys, J. (2020). Global palliative care education in the time of COVID-19. Journal of Pain and Symptom Management, 60(4), e14-e19. https://doi.org/10.1016/j.jpainsymman.2020.07.018

Hannon, B., Zimmermann, C., Knaul, F. M., Powell, R. A., Mwangi-Powell, F. N., & Rodin, G. (2016). Provision of palliative care in low-and middle-income countries: Overcoming obstacles for effective treatment delivery. Journal of Clinical Oncology, 34(1), 62-68. https://doi.org/10.1200/JCO.2015.62.1615

Harding, R., Selman, L., Powell, R. A., Namisango, E., Downing, J., Merriman, A., Ali, Z., Gikaara, N., Gwyther, L., & Higginson, I. (2013). Research into palliative care in sub-Saharan Africa. The Lancet Oncology, 14(4), e183-e188. https://doi.org/10.1016/S1470-2045(12)70396-0

Head, B. A., Schapmire, T. J., Earnshaw, L., Chenault, J., Pfeifer, M., Sawning, S., & Shaw, M. A. (2016). Improving medical graduates’ training in palliative care: Advancing education and practice. Advances in Medical Education and Practice, 7, 99–113. https://doi.org/10.2147%2FAMEP.S94550

Iida, K., Ryan, A., Hasson, F., Payne, S., & McIlfatrick, S. (2021). Palliative and end‐of‐life educational interventions for staff working in long‐term care facilities: An integrative review of the literature. International Journal of Older People Nursing, 16(1), e12347. https://doi.org/10.1111/opn.12347

Ingleton, C., Gardiner, C., Seymour, J. E., Richards, N., & Gott, M. (2013). Exploring education and training needs among the palliative care workforce. BMJ Supportive & Palliative Care, 3(2), 207-212. http://dx.doi.org/10.1136/bmjspcare-2012-000233

Jack, B. A., Kirton, J. A., Birakurataki, J., & Merriman, A. (2012). The personal value of being a palliative care community volunteer worker in Uganda: A qualitative study. Palliative Medicine, 26(5), 753-759. https://doi.org/10.1177/0269216311413628

Korstjens, I., & Moser, A. (2018). Series: Practical guidance to qualitative research. Part 4: Trustworthiness and publishing. European Journal of General Practice, 24(1), 120-124. https://doi.org/10.1080/13814788.2017.1375092

Martins Pereira, S., Fonseca, A. M., & Sofia Carvalho, A. (2011). Burnout in palliative care: A systematic review. Nursing Ethics, 18(3), 317-326. https://doi.org/10.1177/0969733011398092

Paal, P., Brandstötter, C., Bükki, J., Elsner, F., Ersteniuk, A., Jentschke, E., Stähli, A., & Slugotska, I. (2020). One-week multidisciplinary post-graduate palliative care training: An outcome-based program evaluation. BMC Medical Education, 20(1), 1-9. https://doi.org/10.1186/s12909-020-02200-7

Pandey, S., Gaire, D., Dhakal, S., Jaishwal, N., Kharel, P. M., & Vaidya, P. (2015). Perception of palliative care among medical students in a teaching hospital. Journal of the Nepal Medical Association, 53(198), 113-117. https://doi.org/10.31729/jnma.2772

Powell, R. A., Mwangi-Powell, F. N., Kiyange, F., Radbruch, L., & Harding, R. (2011). Palliative care development in Africa: how can we provide enough quality care? BMJ Supportive & Palliative Care, 1(2), 113-114. https://doi.org/10.1136/bmjspcare-2011-000101

Rawlinson, F. M., Gwyther, L., Kiyange, F., Luyirika, E., Meiring, M., & Downing, J. (2014). The current situation in education and training of health-care professionals across Africa to optimise the delivery of palliative care for cancer patients. Ecancermedicalscience, 8, 492. https://doi.org/10.3332/ecancer.2014.492

Reigada, C., Ribeiro, J. L. P., & Novellas, A. (2014). Educational programs for family caregivers in paliative care: a literature review. Journal of Palliative Care and Medicine, 4(5). http://dx.doi.org/10.4172/2165-7386.1000195

Rhee, J. Y., Garralda, E., Namisango, E., Luyirika, E., de Lima, L., Powell, R. A., & Centeno, C. (2018). The African Palliative Care Association (APCA) atlas of palliative care development in Africa: A comparative analysis. The Lancet Global Health, 6, S21. https://doi.org/10.1016/S2214-109X(18)30150-5

Rochmawati, E., Wiechula, R., & Cameron, K. (2016). Current status of palliative care services in Indonesia: A literature review. International Nursing Review, 63(2), 180-190. https://doi.org/10.1111/inr.12236

Sieh, S. B., Sieh, C. V. M., Desmond, J., & Machalaba, C. C. (2019). Providing dignified palliative care services in Liberia. Annals of Global Health, 85(1), 124. https://doi.org/10.5334%2Faogh.2590

Stephens, M. T. (2022). Exploration of palliative care education and training in Liberia: A qualitative study [Thesis, Universitas Muhammadiyah Yogyakarta]. Yogyakarta, Indonesia. https://etd.umy.ac.id/id/eprint/33612/

Stephens, M. T., & Rochmawati, E. (2022). The need for palliative care education and training in Liberia and Indonesia : A literature review. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 7(1), 277–286. https://doi.org/10.30604/jika.v7i1.881

Suprayitno, E., & Setiawan, I. (2021). Nurses’ roles in palliative care: An Islamic perspective. Belitung Nursing Journal, 7(1), 50-54. https://doi.org/10.33546/bnj.1254

Virdun, C., Brown, N., Phillips, J., Luckett, T., Agar, M., Green, A., & Davidson, P. M. (2015). Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach. Collegian, 22(4), 421-431. https://doi.org/10.1016/j.colegn.2014.07.001