Home-based palliative services are at the initial stage in Pakistan. Palliative care is a multidisciplinary approach that are based on prevention and relieving suffering as well as promoting the optimal wellbeing of patients and their families. The purpose of this project was to explore the knowledge and utilization of palliative care services. In addition, the project aimed to improve the quality and utilization of palliative care services based on the identified needs and challenges.
Methodology:
The project was done into two phases. In phase one, a need assessment was performed by interviewing 80 patients or their families who have utilized home health care services and experienced palliative care. In phase two, based on the identified needs, we employed several interventions to improve the utilization of palliative care services.
Results:
The findings of need assessment revealed that 46% of the families were not well aware about palliative care and comfort care. Regarding the reasons for not utilizing services, 21% verbalized about financial issues and 33% family reported about socio-cultural issues. Like one of the participants expressed that “death is a natural process and we don’t see any reason to call a doctor”. Based on the findings extracted from this survey, we introduced palliative doctor and nurses’ round in inpatient areas due to which many of the patients were referred to avail home health care services.
We also observed the ratio of patients requiring palliative care in emergency department gradually decreased. Most of the patients were managed for end of life care in home setting, which eventually influenced upon family’s economic burden. For finance issues, families were asked to consult welfare department. Furthermore, patient’s family were taught about the skills like: Stoma care, NG feeding and PEG feeding.
Conclusion:
In Pakistan, the concept of palliative care is very new and is associated with ethical, moral and sociocultural aspects of patients and their families. Nurses can significantly contribute an important role for the promotion of home health care services.
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