Ugandan Nurses’ Experiences and Perceptions of Providing Palliative Care in a Non-Palliative Hospital Setting

Abstract: Introduction: Uganda is seen as a leading country in Africa regarding palliative care, but still far from all dying patients receive this specialized care. Many of them decease in non- palliative hospital wards, taken care of by nurses who do not have specialized education in palliative care. No research has been done in Uganda where these nurses’ experiences and perceptions of providing palliative care has been examined. Purpose: To describe the experiences and perceptions of providing palliative care among general nurses in a non-palliative medicine ward at Mulago hospital in Kampala, Uganda. Method: A qualitative method was used consisting of semi-structured interviews with seven general nurses working in a non-palliative medicine ward at Mulago Hospital in Kampala, Uganda. The participants were chosen through convenience sampling, and the data were analyzed by a qualitative content analysis. The results were discussed on the basis of the theoretical framework chosen for this study, the cognitive-motivational-relational theory of Lazarus. Results: In this study five categories were identified: providing palliative care by own preconditions, giving symptom relief, involving the relatives, informing and communicating and working in a team. The nurses were familiar with the concept of palliative care but their knowledge about it was limited, often perceiving it as mostly being about physical pain relief. The nurses showed a willingness to improve their work with end-of-life care, but problems like staff shortage and lack of knowledge were described as hindering. To communicate with the patients and their relatives was identified as the biggest challenge among the nurses. Conclusion:  The nurses experienced providing palliative care as difficult in many aspects such as communicating, symptom relief, teamwork and supporting relatives. They described the providing of palliative care as being emotionally challenging. Staff shortage and lack of knowledge and resources were perceived as hinders, preventing them from doing a good job. Overall the nurses wished more education in the subject, showing a willingness to improve their work with palliative patients.