Issues and Challenges of providing Palliative Care in Saudi Arabia, Nursing Perspective.

Transcription

1 Issues and Challenges of providing Palliative Care in Saudi Arabia, Nursing Perspective. Gassan Abudari RN, BSN Palliative Care Clinical Nurse Coordinator King Faisal Specialist Hospital and Research Centre Burden of Cancer in the Gulf Region

2 Symptom Prevalence in Patients with Cancer * * Reilly, C. M., Bruner, D. W., Mitchell, S. A., Minasian, L. M., Basch, E., Dueck, A. C., Cella, D. & Reeve, B. B A literature synthesis of symptom prevalence and severity in persons receiving active cancer treatment. Supportive Care in Cancer, 21,

3 Cancer figure among the leading causes of death worldwide. Accounting for 8.2 million deaths in (World Health Organization 2012)

4 Ten Leading Cancer Types for the Estimated New Cancer Cases and Deaths by Sex, United States, *Estimates are rounded to the nearest 10 and exclude basal cell and squamous cell skin cancers and in situ carcinoma except urinary bladder. Siegel, R., Naishadham, D. & Jemal, A Cancer statistics, CA: a cancer journal for clinicians, 63,

5 Active Treatment PC D E A T H Cure/Life-prolonging Intent Palliative/ Comfort Intent D E A T H

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8 Palliative care in Saudi Arabia. The first palliative care service in Saudi Arabia was started in King faisal hospital in Palliative care remains an isolated provision, with no integration in the health care system.* * Alsirafy SA, Hassan AA, Al-Shahri MZ (2009) Hospitalization pattern in a hospital-based palliative care program: an example from Saudi Arabia. Am J Hosp Palliat Care 26(1): 52 6.

9 Palliative care in Saudi Arabia A total of 12,605 new cancer cases were admitted for treatment at KFSH&RC-Riyadh between 2007 and 2011.* 700 patients seen by palliative care team yearly. * King Faisal Specialist Hospital and Research Centre Tumor registry anual report 2011 New 6 Final.pdf [Online]

10 Issues and challenges Policies and Regulations Culture and Public awareness Medication Availability Education

11 Issues and challenges Policies and Regulation laws that acknowledge and define that palliative care is part of the health care system. National standards of care describing palliative care. Clinical guidelines and protocols. A national strategy on palliative care implementation. Infrastructure of the primary healthcare, home healthcare and community services.

12 Issues and challenges Medication Availability Limited availability of opioids and specific palliative care medication on the primary health care sector. Policy restriction (prescribing, dispensing and administration) Lack of training and experience of non specialized palliative care professionals in safely using such medication

13 Issues and challenges Culture and Public Awareness Misconceptions regarding the use of opioids for pain relief. Lack of public awareness campaign. Family decision making.

14 Education Issues and challenges Lack of palliative education in medical schools. Late referral 26% missed referral misconception of palliative care as care of the dying lack of knowledge about opioids practice Lack of palliative education in nursing schools and postgraduate education. Lack of PC education in other healthcare disciplines (social work, physiotherapy, etc)

15 Nursing Education Issues and challenges Lack of knowledge is considered one of the most common barriers to deliver quality palliative care. Personal experience and attitude can affect the quality of care provided. Saudi healthcare system depends mainly on expatriate nurses (more than 30 different nationalities) Palliative care integration into the health-care system of the country in which nurses train significantly influences their knowledge of and attitudes towards palliative care.

16 Implementations/Recommendations Improving palliative care in Saudi Arabia requires a nation-wide strategy. Establishing palliative care services at all levels of the health-care system. Integrating palliative care into medical, nursing and other healthcare disciplines curricula. Expanding palliative care education courses at national level for postgraduate. Ongoing palliative care nursing education courses at hospitals level. Advanced nurse practitioner, link nurse.

17 References Abudari, G., Zahreddine, H., Hazeim, H., Assi, M. A. & Emara, S Knowledge of and attitudes towards palliative care among multinational nurses in Saudi Arabia. International journal of palliative nursing, 20, Alshammary, S., Abdullah, A., Duraisamy, B. & Anbar, M Palliative care in Saudi Arabia: Two decades of progress and going strong. Journal of Health Specialties, 2, 59. Alsirafy SA, Sroor MY, Al-Shahri MZ (2010) Referral timing of in-hospital cancer deaths to palliative care in a Saudi tertiary care hospital. Progress in Palliative Care 18:85 88 Alamri SH (2012) Knowledge of the residents at King Abdul- Aziz University Hospital (KAAUH) about palliative care. J Family Community Med 19(3):

18 T H A N K Y O U