An assessment of the integration of palliative care in the caring of cancer patients in selected oncology clinics in the eThekwini district in KwaZulu-Natal

Abstract

Palliative care research in South Africa is at an early stage and there is an increasing need to develop a body of evidence that is relevant to South African conditions. One of the biggest challenges that palliative care in Africa faces is the projected increase in the number of cancer patients in the developing world by 2050, many of whom will need palliative care. There is a concern at present about the integration of oncology and palliative care services in South Africa and whether or not cancer patients are able to access quality palliative care. Palliative care plays an important role in improving quality of life for people and family members affected by life-threatening illness. It pursues its goal by relieving pain and other distressing symptoms in cancer patients and giving psychosocial support to patients and their families. It should begin at diagnosis and continue throughout treatment, follow-up care, and at the end of life in addition to the cancer treatment which is given Aim of the study The aim of this study was to assess the integration of palliative care in the caring of cancer patients in the selected oncology clinics in the eThekwini district in KZN. Methodology A qualitative, explorative, descriptive and contextual research design was used to guide this study. The study was participative in nature and employed a focus group methodology. The participants in this study were professional nurses who were working at the selected sites in the public urban oncology clinics for more than three months. Two focus groups were conducted within one month of each other at selected oncology sites with participation from 16 oncology nurses. Findings Findings indicated that most participants understood palliative care as end of life care when a patient is beyond curative treatment and that it is often the doctor who determines eligibility. Participants also perceived palliative care in terms of different types of medical treatment. The findings indicated nurses only contacted hospices when the patient was at the last stage of their illness, were often not aware of all the hospices in the area, and acknowledged that communication between the oncology clinics and hospices was not good. Some nurses believed that palliative care is also provided in the oncology clinic and that it is not only the hospices that provide palliative care. Only one oncology nurse who participated in the study mentioned that she is trained in palliative care, but they all showed interest in becoming more knowledgeable in this area and improving relationships between oncology clinics and the palliative care team/hospices.