An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi

dc.contributor.advisorGanca
dc.contributor.advisorLinda
dc.contributor.advisorBates, Jane
dc.contributor.authorChitani, Alex Jackson
dc.date.accessioned2019-03-01T11:51:01Z
dc.date.available2019-03-01T11:51:01Z
dc.date.issued2018
dc.date.updated2019-02-22T13:49:40Z
dc.description.abstractBackground For patients to have a dignified death, their wishes should be known and respected. The challenge is that, if conversations about death are avoided by patients, their families and health professionals because talking about death is taboo, it becomes hard to plan and implement preferred care for such patients. The researcher undertook an exploration of patients’ preferences and priorities for end-of-life care at Tiyanjane Clinic for palliative care, Queen Elizabeth Central Hospital, Blantyre, Malawi. The topic is regarded as sensitive and taboo in Malawi because discussing end-of-life care preferences and priorities is taken as prophesying death. Methodology This was a qualitative, descriptive study. Equal opportunity to participate in the study was provided to all adult patients diagnosed with life-threatening illnesses at the Clinic. Most participants were infected with the HIV virus. Data was collected by means of semi-structured interviews that were recorded and afterwards transcribed verbatim. A thematic framework was used to inform the systematic approach to data analysis. Results In December 2015 and January 2016, interviews were conducted with 14 adults (six men and eight women). The following 10 themes emerged from the data: Awareness of reason for being at Tiyanjane; reluctance to mention HIV; psychosocial concerns, expressed emotions; legacy; receiving information; decision-making; place of care; place of death; and spiritual concerns. Conclusion This research shows that, although choices are limited in Malawi due to a lack of resources, patients need to be given an opportunity to make their own healthcare choices. This research has shown that it is not as hard to start end-of-life care conversations as previously thought. Further research needs to explore whether advance directives or legal wills should be offered as part of care for palliative patients in Malawi, as most of the participants highlighted the need to be heard in regard to their wishes being upheld after death.
dc.identifier.apacitationChitani, A. J. (2018). <i>An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/29891en_ZA
dc.identifier.chicagocitationChitani, Alex Jackson. <i>"An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2018. http://hdl.handle.net/11427/29891en_ZA
dc.identifier.citationChitani, A. 2018. An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Chitani, Alex Jackson AB - Background For patients to have a dignified death, their wishes should be known and respected. The challenge is that, if conversations about death are avoided by patients, their families and health professionals because talking about death is taboo, it becomes hard to plan and implement preferred care for such patients. The researcher undertook an exploration of patients’ preferences and priorities for end-of-life care at Tiyanjane Clinic for palliative care, Queen Elizabeth Central Hospital, Blantyre, Malawi. The topic is regarded as sensitive and taboo in Malawi because discussing end-of-life care preferences and priorities is taken as prophesying death. Methodology This was a qualitative, descriptive study. Equal opportunity to participate in the study was provided to all adult patients diagnosed with life-threatening illnesses at the Clinic. Most participants were infected with the HIV virus. Data was collected by means of semi-structured interviews that were recorded and afterwards transcribed verbatim. A thematic framework was used to inform the systematic approach to data analysis. Results In December 2015 and January 2016, interviews were conducted with 14 adults (six men and eight women). The following 10 themes emerged from the data: Awareness of reason for being at Tiyanjane; reluctance to mention HIV; psychosocial concerns, expressed emotions; legacy; receiving information; decision-making; place of care; place of death; and spiritual concerns. Conclusion This research shows that, although choices are limited in Malawi due to a lack of resources, patients need to be given an opportunity to make their own healthcare choices. This research has shown that it is not as hard to start end-of-life care conversations as previously thought. Further research needs to explore whether advance directives or legal wills should be offered as part of care for palliative patients in Malawi, as most of the participants highlighted the need to be heard in regard to their wishes being upheld after death. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi TI - An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi UR - http://hdl.handle.net/11427/29891 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/29891
dc.identifier.vancouvercitationChitani AJ. An exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi. []. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/29891en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPalliative Medicine
dc.titleAn exploration of patients' preferences and priorities for end-of-life care at Titanjane Clinic for Palliative Care, Queen Elizabeth Central Hospital, Blantyre, Malawi
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhil
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