TABLE OF CONTENTS
ABSTRACT. ii
TABLE OF CONTENTS……………………………....………………………iii
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study. 1
1.2 Statement of the Problem.. 3
1.3 Objectives of the Study. 5
1.4 Research Questions. 5
1.5 Research Hypothesis. 6
1.6 Significance of the Study. 6
1.7 Scope of the Study. 7
1.8 Limitations of the Study. 7
1.9 Organization of the Study. 8
CHAPTER TWO
REVIEW OF RELATED LITERATURE
2.1 Introduction. 9
2.2 Theoretical Review.. 9
2.2.1 Cultural Competence Theory. 9
2.2.2 Collaborative Care Theory. 10
2.2.3 Educational Empowerment Theory. 10
2.2.4 Policy Advocacy Theory. 10
2.3 Conceptual Review.. 11
2.3.1 Overview.. 11
2.3.2 Cultural Competence in Palliative Care. 12
2.3.3 Collaborative Care Approach. 12
2.3.4 Educational Empowerment 12
2.3.5 Policy Advocacy for Palliative Care. 13
2.3.6 Community Engagement and Awareness. 13
2.3.7 Addressing Spiritual Needs. 13
2.3.8 Challenges and Opportunities. 14
2.3.9 Quality of Life and Patient-Centered Care. 14
2.3.10 The Impact of Nurse-Patient Communication. 14
2.4 Empirical Review.. 15
2.5 Summary of Literature Review.. 17
CHAPTER THREE
RESEARCH METHODOLOGY
3.1 Introduction. 18
3.2 Research Design. 18
3.3 Study Population. 18..................................................................
3.4 Sampling Technique………………………………………………....19
3.5 Sample Size. 19
3.6 Data Collection Methods. 20
3.7 Data Analysis Techniques. 21
3.8 Ethical Considerations. 21
3.9 Limitations of the Study. 22
3.10 Conclusion. 22
CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
4.1 Preamble. 24
4.2 Socio-Demographic Characteristics of Respondents. 24
4.3 Analysis of the Respondents’ Views on Research Question one: 28
4.4 Testing Hypothesis. 40
4.5 Discussion of Findings. 42
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSION AND RECOMMENDATIONS
5.1 Summary of Findings. 45
5.2 Conclusion. 46
5.3 Recommendations. 47
REFERENCES. 49
APPENDICES. 55
Appendix I: Research Questionnaire. 55
CHAPTER ONE
INTRODUCTION
1.1 Background to the Study
Medical science and practice have been profoundly impacted by health technology breakthroughs over the past decades. According to the World Health Organization [WHO], the average life expectancy at birth increased from 58% in 2009 to 71% in 2015. More people are receiving diagnoses for age-related chronic illnesses like cancer, heart disease, and stroke as life expectancy keeps rising. People with chronic and incapacitating illnesses must receive care that guarantees they maintain the highest Quality of Life (QoL) for as long as possible due to the increase in life expectancy (Anyanwu and Agbedia, 2020). This demonstrates how palliative care is becoming increasingly important.
Palliative care is an interventional strategy designed to enhance the HRQOL (health-related quality of life) of patients with life-threatening conditions. Palliative care, according to the World Health Organization [WHO] (2018), is an “approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychological and spiritual.” Its fundamental principles include alleviating suffering and offering consolation in order to preserve HRQOL for as long as possible (Kassa et al.,, 2014). Accordingly, it is a medical option that aids terminally ill patients who are without other options for treatment (Pope, 2013).
In contrast, end-of-life care, which is a crucial part of palliative care, is meant to support people in their last year of life, which is typically the last six months (Krau, 2016). By helping them manage their physical difficulties and respecting their desires as they near death, this kind of care preserves people's dignity through kind words and deeds. The aim is to reduce suffering and pain while honoring the dying person's wishes, not to prolong life. According to Taylor et al., the ultimate goal of end-of-life care is to improve the quality of life for patients by enabling them to pass away in a respectable and tranquil manner. 2020; Glass et al. 2001; Harstäde et al. (2002); Taylor and Kurent (2002). in 2018.
Palliative care and end-of-life care are two forms of care that are similar but have distinct functions. Patients may benefit from palliative care even though they may not respond to end-of-life care. While palliative care concentrates on symptom management, end-of-life care aims to ensure a dignified death and to reduce the patient's pain during the dying process. The last phases of palliative care may include end-of-life care. It is crucial to remember that end-of-life care is not just for hospices or palliative wards; it should be accessible to anyone who needs it during the dying process, whether they are in a hospital's palliative ward, an intensive care unit, or their home. Every person has the right to die peacefully and with dignity (Nacak and Erden, 2022).
Palliative and end-of-life care is a crucial component of healthcare services in Nigeria and many other parts of the world. Due to the growing prevalence of this kind of care, nurses must have the necessary training and expertise. In almost every nation, nurses make up the largest group of healthcare professionals (Kassa et al. 2014). From diagnosis to survivorship and even the dying process, they assist patients at every stage of their illness (Ali and Ayoub, 2010). In essence, especially in developing countries, nurses frequently act as the primary caregivers. Because of their special position, they are able to develop deep connections with patients and their families, which promotes open communication about treatment alternatives, care objectives, and advance care planning and helps to build trust (O'Connor et al. (2019).
Given their place in the healthcare system, nurses are essential to the delivery of palliative care and end-of-life care in both teams and systems (Qadire, 2014; WHO, 2014). The purpose of this essay is to provide an overview of the current situation regarding nursing's role in end-of-life and palliative care in Nigeria.Bottom of Form
1.2 Statement of the Problem
Palliative and end-of-life care is a critical component of healthcare aimed at improving the quality of life for patients facing life-threatening illnesses. Despite its importance, the role of nurses in providing palliative and end-of-life care is often underestimated. Although nurses make up the largest group of healthcare professionals, there is a scarcity of knowledge of their role in carrying out palliative and end-of-life care across institutions and their place of work in the healthcare system.
However, some studies have looked at the nurse's role in a specific field or from a specific nursing perspective. Walshe and Luker (2010) did a review of 46 papers to construct a detailed account of the district nurse's role in providing palliative care. Offen (2015) did a meta-ethnography on the district nurse's role in palliative care. The study found, among other things, uncertainty surrounding the nurse's role. In another literature review of the role of the specialist palliative care nurses in the community (Mulvihill, Harrington, & Robertson, 2010), one of the findings was a need for clarification of the nurse's role. These reviews, which are all from the same level of health care, namely home care, demonstrate a need for clarification of the nurse's role. Knowing that the profession of nursing may be difficult to describe, there is a need for clarifying its role and function, not least in the cooperation with other professions in a multidisciplinary team, so crucial in palliative care. This study aims to examine the role of nurses in the multidisciplinary team at the University of Uyo Teaching Hospital (UUTH), Uyo, in promoting and delivering palliative and end-of-life care.
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1.3 Objectives of the Study
The main objective of the study is to examine the role of nurses in promoting palliative care and end-of-life care in Nigeria. Specific objectives of the study are:
- Assess the current knowledge and attitudes of nurses in Nigeria towards palliative care and end-of-life care
- Identify the barriers and facilitators for effective nurse-led palliative care and end-of-life care integration in the Nigerian healthcare system
- Develop and evaluate effective strategies for enhancing the role of nurses in promoting palliative care and end-of-life care in Nigeria
1.4 Research Questions
To guide the study and achieve the objectives of the study, the following research questions were formulated:
- What is the level of knowledge among nurses in Nigeria about the principles and practices of palliative care and end-of-life care?
- What are the major barriers faced by nurses when delivering palliative care and end-of-life care in Nigerian healthcare settings?
- What are the most effective educational and training interventions for improving nurses' knowledge and skills in palliative care and end-of-life care?
1.5 Research Hypothesis
The following research hypothesis was developed and tested for the study:
Ho: There is no statistical significant relationship between nurses and promoting palliative care and end-of-life care in Nigeria.
1.6 Significance of the Study
The study is important for many reasons. The following are the major stakeholders this paper through its practical and theoretical implications and findings will be of great significance:
Firstly, the paper will benefit major stakeholders and policy makers in the Nursing Science sector. The various analysis, findings and discussions outlined in this paper will serve as a guide in enabling major positive changes in the industry and sub-sectors.
Secondly, the paper is also beneficial to the organizations used for the research. Since first hand data was gotten and analysed from the organization, they stand a chance to benefit directly from the findings of the study in respect to their various organizations. These findings will fast track growth and enable productivity in the organisations used as a case study.
Finally, the paper will serve as a guide to other researchers willing to research further into the subject matter. Through the conclusions, limitations and gaps identified in the subject matter, other student and independent researchers can have a well laid foundation to conduct further studies.
1.7 Scope of the Study
The study is delimited to UUTH, Uyo. Findings and recommendations from the study reflects the views and opinions of respondents sampled in the area. It may not reflect the entire picture in the population.
1.8 Limitations of the Study
The major limitations of the research study are time, financial constraints and delays from respondents. The researcher had difficulties combining lectures with field work. Financial constraints in form of getting adequate funds and sponsors to print questionnaires, hold Focus group discussions and logistics was recorded. Finally, respondents were a bit reluctant in filling questionnaires and submitting them on time. This delayed the project work a bit.
1.9 Organization of the Study
The study is made up of five (5) Chapters. Chapter one of the study gives a general introduction to the subject matter, background to the problem as well as a detailed problem statement of the research. This chapter also sets the objectives of the paper in motion detailing out the significance and scope of the paper.
Chapter Two of the paper entails the review of related literature with regards to corporate governance and integrated reporting. This chapter outlines the conceptual reviews, theoretical reviews and empirical reviews of the study.
Chapter Three centers on the methodologies applied in the study. A more detailed explanation of the research design, population of the study, sample size and technique, data collection method and analysis is discussed in this chapter.
Chapter Four highlights data analysis and interpretation giving the readers a thorough room for the discussion of the practical and theoretical implications of data analyzed in the study.
Chapter Five outlines the findings, conclusions and recommendations of the study. Based on objectives set out, the researcher concludes the paper by answering all research questions set out in the study.
