Palliative care skills training needed for health-care staff in sub-Saha...( A new study led by Lucy Selman and col...),Health

A new study, led by Lucy Selman and colleagues from King's College London, has found that patients with incurable, progressive diseases and their family carers in sub-Saharan Africa often do not receive enough information about the patient's disease and its management, which impacts negatively on their ability to cope with illness. The results of the study have been published online by the BMJ today.

The study was conducted in collaboration with five palliative care services in South Africa and Uganda and the palliative care associations of South Africa (HPCA) and Africa (APCA).

A major finding from interviews with 90 patients and 38 family carers was that healthcare staff did not provide enough information to help patients and carers understand the disease, its causes and symptoms, as well as its treatment and management. Patients and carers also felt insufficiently informed about the financial and social support available to them. These information gaps can cause anxiety for the patient and affect the family's ability to provide good patient care.

Patients and carers drew on a wide range of sources for information, including friends and family, peers with a similar condition and the media. Although patients and carers appreciated efforts made by their palliative care team to provide information, many still had unanswered questions.

For example, a patient with HIV reported that hospital staff never properly explained his diagnosis, likely symptoms and future care. Other patients talked about not receiving the results of blood tests, and described the trauma of being broken bad news in an insensitive manner. Carers reported not being told the patient's diagnosis directly, but learning it from his or her medical notes or from simply being sent on an HIV education course.

'The poor knowledge and lack of information provided impacted negatively on patients' and carers' ability to cope with their situation. For
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