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Qualitative analysis of palliative care for pediatric patients with cancer at Bugando Medical Center: An evaluation of barriers to providing end-of-life care in a resource-limited setting

dc.contributor.author Esmaili, BE
dc.contributor.author Masalu, N
dc.contributor.author Schroeder, Kristin M
dc.contributor.author Stewart, K
dc.date.accessioned 2018-03-01T15:43:41Z
dc.date.available 2018-03-01T15:43:41Z
dc.date.issued 2018-03-01
dc.identifier.issn 2378-9506
dc.identifier.uri https://hdl.handle.net/10161/16143
dc.description.abstract Purpose Palliative care remains an urgent, neglected need in the developing world. Global disparities in end-of-life care for children, such as those with advanced cancers, result from barriers that are complex and largely unstudied. This study describes these barriers at Bugando Medical Center, one of three consultant hospitals in Tanzania, to identify areas for palliative care development suitable to this context. Methods In-depth interviews were conducted with 20 caregivers of pediatric patients with cancer and 14 hospital staff involved in pediatric end-of-life care. This was combined with 1 month of participant observation through direct clinical care of terminally ill pediatric patients. Results Data from interviews as well as participant observation revealed several barriers to palliative care: financial, infrastructure, knowledge and cultural (including perceptions of pediatric pain), and communication challenges. Although this study focused on barriers, what also emerged were the unique advantages of end-of-life care in this setting, including community cohesiveness and strong faith background. Conclusion This study provides a unique but focused description of barriers to palliative care common in a low-resource setting, extending beyond resource needs. This multidisciplinary qualitative approach combined interviews with participant observation, providing a deeper understanding of the logistical and cultural challenges in this setting. This new understanding will inform the design of more effective—and more appropriate—palliative care policies for young patients with cancer in the developing world.
dc.publisher American Society of Clinical Oncology
dc.relation.ispartof Journal of Global Oncology
dc.relation.isversionof 10.1200/JGO.17.00047
dc.title Qualitative analysis of palliative care for pediatric patients with cancer at Bugando Medical Center: An evaluation of barriers to providing end-of-life care in a resource-limited setting
dc.type Journal article
pubs.author-url http://10.0.4.176/JGO.17.00047
pubs.issue 1
pubs.organisational-group Duke
pubs.organisational-group Duke Global Health Institute
pubs.organisational-group Duke Science & Society
pubs.organisational-group Initiatives
pubs.organisational-group Institutes and Provost's Academic Units
pubs.organisational-group University Institutes and Centers
pubs.volume 4


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