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PSYCHOSOCIAL CHALLENGES EXPERIENCED BY PATIENTS AT TERMINAL STAGE OF ILLNESS _AND THEIR PERCEPTION OF PALLIATIVE NURSING CARE IN TERTIARY HOSPITALS IN ENUGU STATE, NIGERIA..

ABSTRACT

 Terminal illness is the term used to describe disease conditions which progressively deteriorate and lead to the death of the patient. Such conditions include cancer and full blown AIDS, among others. The diagnosis of terminal illness in a person evokes lot of both physical and psychosocial challenges. The physical challenges are easily observable by healthcare-providers while subjective psychological challenges are scarcely unexplored. There is a dearth of research about the psychosocial challenges experienced by these patients. This study investigated the psychosocial challenges experienced by hospitalized cancer patients (stage III & IV) and their perception of palliative nursing care received in tertiary hospitals in Enugu State. The understanding of these psychosocial challenges experienced and expressed by these patients is crucial in effecting timely and appropriate palliative nursing care intervention. Descriptive phenomenological qualitative design was used which provided opportunity for the participants to express experiences in narrative form freely. Eighteen participants purposively participated and data were collected using researcher developed interview guide and their responses tape recorded. Data were analysed thematically, using Tesch & Giorgi's approach. The findings revealed that the psychological challenges experienced by the participants included devastation, anger, loss of control, loneliness, withdrawal from relationships and an overwhelming sense of powerlessness to function independently, anxiety, worry, sadness/depression and fear about the disease outcome. Social challenges experienced included limitations in performing their activities of daily living (ADL); dependency on others for care; difficulty in communicating with healthcare-providers, some family members and friends; financial difficulties; lack/poor encouragement from family members/friends as well as irregular visitation. Majority of the participants did not experience spiritual challenges; instead, the illness moved them closer to their God. The psychosocial challenge mostly experienced by the participants was worry about the outcome of the illness and their family welfare. The participants' perception of palliative nursing care revealed that nurses did not understand the depth of their psychological needs and care; nurses knew the disease outcome but don't know what to tell them; nurse-patient relationship was isolating and not close; nurses were too busy with their office work, and did not answer their calls promptly but served their medication promptly; nurses did not attend to their ADL needs regularly; and that nurses prayed for them only at night. The participants most valued care were treating them with love, respect and concern through making time to talk with them and listen, for them to unburden their minds; and attending promptly to their ADL needs. In conclusion, the participants had lots of psychosocial challenges and perceived that the palliative nursing care received to help them cope with the challenges were not satisfactory. In recommendation, there is need for knowledge update of palliative nursing care in tertiary hospitals to ensure that these patients receive holistic care from experts.

Project detailsContents
 
Number of Pages89 pages
Chapter one Introduction
Chapter two Literature review
Chapter three  methodology
Chapter  four  Data analysis
Chapter  five Summary,discussion & recommendations
ReferenceReference
QuestionnaireQuestionnaire
AppendixAppendix
Chapter summary1 to 5 chapters
Available documentPDF and MS-word format


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