Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Palliative Care
Published in: BMC Palliative Care 1/2020

01-12-2020 | Cervical Cancer | Research article

Limited knowledge and access to palliative care among women with cervical cancer: an opportunity for integrating oncology and palliative care in Zimbabwe

Authors: O. Tapera, A. M. Nyakabau

Published in: BMC Palliative Care | Issue 1/2020

Login to get access

Abstract

Background

Cervical cancer is mostly diagnosed at advanced stages among the majority of women in low-income settings, with palliative care being the only feasible form of care. This study was aimed at investigating palliative care knowledge and access among women with cervical cancer in Harare, Zimbabwe.

Methods

Sequential mixed methods design was used, consisting of two surveys and a qualitative inquiry. A census of 134 women diagnosed with cervical cancer who visited two cancer treating health facilities and one palliative care provider in Harare between January and April, 2018 were enrolled in the study. Seventy-eight health workers were also enrolled in a census in the respective facilities for a survey. Validated structured questionnaires in electronic format were used for both surveys. Descriptive statistics were generated from the surveys after conducting univariate analysis using STATA. Qualitative study used interview/discussion guides for data collection. Thematic analysis was conducted for qualitative data.

Results

Mean ages of patients and health workers in the surveys were 52 years (SD = 12) and 37 years (SD = 10,respectively. Thirty-two percent of women with cervical cancer reported knowledge of where to seek palliative care. Sixty-eight percent of women with cervical cancer had received treatment, yet only 13% reported receiving palliative care. Few women with cervical cancer associated treatment with pain (13%) and side effects (32%). More women associated cervical cancer with bad smells (81%) and death (84%). Only one of the health workers reported referring patients for palliative care. Seventy-six percent of health workers reported that the majority of patients with cervical cancer sourced their own analgesics from private pharmacies. Qualitative findings revealed a limited or lack of cervical cancer knowledge among nurses especially in primary health care, the existence of stigma among women with cervical cancer and limited implementation of palliative policy.

Conclusions

This study revealed limited knowledge and access to palliative care in a low-income setting due to multi-faceted barriers. These challenges are not unique to the developing world and they present an opportunity for low-income countries to start considering and strategizing the integration of oncology and palliative care models in line with international recommendations.
Literature
1.
Wu ES, Jeronimo J, Feldman S. Barriers and challenges to treatment alternatives for early-stage cervical cancer in lower-resource settings. Journal of Global Oncology. 2017;3(5):572–82.CrossRef
2.
E Chokunonga, MZ Borok, T Chingonzoh, ZM Chirenje, R Maakunike-Mutasa, P Manangira et al.: Patterns of Cancer in Zimbabwe in 2016, Zimbabwe National Cancer Registry, 2018.
3.
Chirenje ZM, Rusakaniko S, Kirumbi L, Ngwalle EW, Makuta-Tlebere P, Kaggwa S, et al. Situation analysis for cervical cancer diagnosis and treatment in east, central and southern African countries. Bull World Health Organ. 2001;79:127–32.PubMedPubMedCentral
4.
Nyakabau AM. Priorities for cancer prevention and control in Zimbabwe. Cancer Control. 2014:126–30.
5.
Grant L, Brown J, Leng M, Bettega N, Murray SA. Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies. BMC palliative care. 2011;10(1):8.CrossRef
6.
Kaasa S, Loge JH, Aapro M, Albreht T, Anderson R, Bruera E, et al. Integration of oncology and palliative care: a lancet oncology commission. The Lancet Oncology. 2018.
7.
Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Kwete XJ, et al. Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the lancet commission report. Lancet. 2018;391(10128):1391–454.CrossRef
8.
Khumalo T, Maasdorp V. The Island Hospice model of palliative care. ecancermedicalscience. 2016;10.
9.
10.
11.
12.
13.
Grande G, Stajduhar K, Aoun S, Toye C, Funk L, Addington-Hall J, et al. Supporting lay carers in end of life care: current gaps and future priorities. Palliat Med. 2009;23(4):339–44.CrossRef
14.
Kangethe S. The perfidious experiences of men as palliative caregivers of people living with HIV/AIDS and other terminal illnesses in Botswana. Eclectic data sources. Indian journal of palliative care. 2010;16(3):174.CrossRef
15.
Creswell JW. Research design: qualitative, quantitative, and mixed methods approaches (4th ed). Thousand Oaks, CA: Sage; 2013.
16.
Kumar K. Conducting key informant interviews in developing countries. Washington,DC: Agency for International Development (AID); 1989. Report No.: 13.
17.
18.
Koffman J, Burke G, Dias A, Raval B, Byrne J, Gonzales J, et al. Demographic factors and awareness of palliative care and related services. Palliat Med. 2007;21(2):145–53.CrossRef
19.
Hirai K, Kudo T, Akiyama M, Matoba M, Shiozaki M, Yamaki T et al. Public Awareness, Knowledge of Availability, and Readiness for Cancer Palliative Care Services: A Population-Based Survey across Four Regions in Japan. Journal of Palliative Medicine. 201; 14 (8): 918–922.CrossRef
20.
21.
Tang P-L, Mayer DK, Chou F-H, Hsiao K-Y. The experience of cancer stigma in Taiwan: a qualitative study of female cancer patients. Arch Psychiatr Nurs. 2016;30(2):204–9.CrossRef
22.
Suwankhong D, Liamputtong P. Breast cancer treatment: experiences of changes and social stigma among Thai women in southern Thailand. Cancer Nurs. 2016;39(3):213–20.CrossRef
23.
Cherny NI. Stigma associated with “palliative care” getting around it or getting over it. Cancer. 2009;115(9):1808–12.CrossRef
24.
Greer JA, Jackson VA, Meier DE, Temel JS. Early integration of palliative care services with standard oncology care for patients with advanced cancer. CA Cancer J Clin. 2013;63(5):349–63.CrossRef
25.
Beccaro M, Costantini M, Merlo DF. Inequity in the provision of and access to palliative care for cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). BMC public health. 2007;7(1):66.CrossRef
26.
Kumar P, Casarett D, Corcoran A, Desai K, Li Q, Chen J, et al. Utilization of supportive and palliative care services among oncology outpatients at one academic cancer center: determinants of use and barriers to access. J Palliat Med. 2012;15(8):923–30.CrossRef
27.
Kwon JH. Overcoming barriers in cancer pain management. J Clin Oncol. 2014;32(16):1727–33.CrossRef
Metadata
Title
Limited knowledge and access to palliative care among women with cervical cancer: an opportunity for integrating oncology and palliative care in Zimbabwe
Authors
O. Tapera
A. M. Nyakabau
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Palliative Care / Issue 1/2020
Electronic ISSN: 1472-684X
DOI
https://doi.org/10.1186/s12904-020-0523-5

Other articles of this Issue 1/2020

BMC Palliative Care 1/2020 Go to the issue

Research article

An exploration of the experiences of professionals supporting patients approaching the end of life in medicines management at home. A qualitative study

Research article

Development and validation of the cancer symptoms discrimination scale: a cross-sectional survey of students in Yunnan, China

Research article

The effect of neuropalliative care on quality of life and satisfaction with quality of care in patients with progressive neurological disease and their family caregivers: an interventional control study

Research article

Two faces of the same coin: a qualitative study of patients’ and carers’ coexistence with chronic breathlessness associated with chronic obstructive pulmonary disease (COPD)

Research article

Frequency of discussing and documenting advance care planning in primary care: secondary analysis of a multicenter cross-sectional observational study

Research article

Patient-centered care during the last year of life: adaptation and validation of the German PACIC short form for bereaved persons as proxies (PACIC-S9-proxy)