ABSTRACT
OBJECTIVES: This study aims to provide an in-depth exploration of everyday spiritual concerns of patients with advanced cancer seeking palliative care in Bangladesh, and assess their spiritual well-being (SWB). METHODS: This study was conducted among 163 patients with advanced cancer from three tertiary care hospitals in Bangladesh. It was divided into two parts: a quantitative segment that assessed the SWB of the participants using the EORTC QLQ SWB32, and a qualitative segment that explored their spiritual history. RESULT: Spirituality was commonly interpreted and understood synonymously with religion by all participants, and their sense of life's meaning centred on their families and friends. The lack of support from religious organisations led to feelings of isolation and disconnection from spiritual communities. Highest scores in SWB were observed in Relationships with God and Someone/Something Greater Scales. The lowest score was observed for Existential fulfilment. Patients expressed a desire for their palliative care team to address their spiritual concerns, regardless of their training in this area. CONCLUSION: Spirituality is a deeply personal aspect of the human experience. Understanding and respecting these beliefs can empower palliative care professionals to deliver culturally sensitive care to their patients, irrespective of their level of training.
ABSTRACT
BACKGROUND: Palliative care is paramount in the modern clinical field worldwide. However, in Bangladesh, its acceptance is limited compared to other related sectors, despite the country suffering from a huge burden of life-limiting diseases. Besides, PC teams and their approach to care are entirely different from the conventional clinical approach. This study aimed to explore the challenges faced by healthcare providers working in the palliative care unit in Bangladesh, including all groups. DESIGN: This was a cross-sectional descriptive survey involving palliative care providers. METHODS: A self-administered pre-tested questionnaire was used for data collection. Data was analyzed using descriptive statistics and Chi-square at p <0.05. RESULT: The mean age of the respondents was 33.59 ± 8.05 years, and barely most (82.5%) had served for 7-9 years. More than half (51%) of doctors and 31% of nurses claimed patient agitation as a challenge. Almost all groups of respondents exhibit ethical dilemma as a barrier, although a significant relationship was found between professional level and ethical dilemma. More than half of doctors (51%), 41.5% of nurses, and 29.5% of PCA-ward staff mentioned the lack of telemedicine facilities as a challenge. Nearly half (47.1%) of doctors and nurses claimed that patients' families had made patient care difficult, on the other hand, PCA-ward staff (70%) group ignorance of family did the same thing. Opioid phobia of other health professionals restricted the growth mentioned by the majority of all four groups of respondents. A significant relationship was found between limited dose formulation and experience of HPs (p<0.07). At the institutional level, 93.3% of nursing staff agreed that the lack of supporting staff was a drawback. A significant relationship was also found between the type of institution and the lack of a support system to conduct home-based care (p<0.002). Moreover, the majority (83.3%) of PCA-WS exhibit a lack of career development opportunities (p<0.001) as a barrier, besides, more than 7 out of 10 doctors (7.2%) felt social discrimination as a challenge(p<0.001). CONCLUSION: Introducing new concepts comes with obstacles, but proper planning and awareness can make it necessary. Incorporating it into primary healthcare can create new job opportunities and increase familiarity among the general population. Training healthcare professionals on opioid handling can also increase its acceptance.