End of Life Care in Uro-Cancers: A Qualitative study at Institute of Kidney Diseases Peshawar
Liaqat Ali, MBBS, FCPS, Associate Professor of Urology, Institute of Kidney Diseases HMC Peshawar Pakistan
Saima Ali, MBBS, FCPS, MHP, Professor of Pediatric Peshawar Medical College Peshawar Pakistan
Nasir Orakzai, MBBS, FRCS, Dip Urology London, Professor of Urology at Institute of Kidney Diseases HMC Peshawar Pakistan
BACKGROUND:
The people of Pakistan are inclined to spirituality in all walks of life especially during the management of terminally ill patients. It is considered a spiritual duty for family members to care for their sick and dying relatives and such care is often seen as a blessed opportunity for close friends. The Pakistani community endorses the Joint Commission on the Accreditation of Healthcare Organizations), that “The assessment of patient’s spiritual needs is required on patients receiving end-of-life care only”. Unfortunately there is no system of chaplains in health care system in Pakistan, but fortunately due to strong bonding with spirituality, the role of clergyman is usually performed by attending doctor or the patient’s attendants.
OBJECTIVES:
To determine the spiritual needs of the terminal ill patients of Urocancers and to study the effect of its provision on coping of disease.
METHODS:
It’s a qualitative study, conducted in department of Urology IKD Peshawar from June 2016 till December 2016 till February 2017. Out of total 980 in patients in study duration, 18 patients died with percentage of 1.8%. Out of 18 patients 12 were suffering from terminal stages of metastatic Uro Cancers. Spiritual needs were identified in 10 patients using structured questioner of FICA. NVIVO was used for analyzing interview.
RESULTS:
10 patients of terminal ill patients of urocancer were identified as spiritually motivated by FICA. Spiritual care was provided by doctors, paramedics and Nurses in form providing Quran, recitation of SuraYaseen, Sura Rahman, SuraFateha and AyatulKursi. Two patients requested for prayers from clergymen. The care oriented model of whole patient care showed positive aptitude of patients towards coping of disease and compliance with medication. Nvivo reveled ” I am very satisfied and relaxed after listening surayaseen” “Now I have no pain as recitation has relaxed me with blessing” “ I am comfortable going into other world O God u forgive me”. All the patients died peacefully and attendants were very satisfied with provision of spiritual care and not even a single patient ended up in complains or enquiry.
CONCLUSION:
The care oriented model is the call of the day from cure oriented model. The provision of spiritual; need of the patients helps significantly in coping and compliance of the patients.
KEY WORDS: Spirituality, Faith healing, end of life care
Saima Ali, MBBS, FCPS, MHP, Professor of Pediatric Peshawar Medical College Peshawar Pakistan
Nasir Orakzai, MBBS, FRCS, Dip Urology London, Professor of Urology at Institute of Kidney Diseases HMC Peshawar Pakistan
BACKGROUND:
The people of Pakistan are inclined to spirituality in all walks of life especially during the management of terminally ill patients. It is considered a spiritual duty for family members to care for their sick and dying relatives and such care is often seen as a blessed opportunity for close friends. The Pakistani community endorses the Joint Commission on the Accreditation of Healthcare Organizations), that “The assessment of patient’s spiritual needs is required on patients receiving end-of-life care only”. Unfortunately there is no system of chaplains in health care system in Pakistan, but fortunately due to strong bonding with spirituality, the role of clergyman is usually performed by attending doctor or the patient’s attendants.
OBJECTIVES:
To determine the spiritual needs of the terminal ill patients of Urocancers and to study the effect of its provision on coping of disease.
METHODS:
It’s a qualitative study, conducted in department of Urology IKD Peshawar from June 2016 till December 2016 till February 2017. Out of total 980 in patients in study duration, 18 patients died with percentage of 1.8%. Out of 18 patients 12 were suffering from terminal stages of metastatic Uro Cancers. Spiritual needs were identified in 10 patients using structured questioner of FICA. NVIVO was used for analyzing interview.
RESULTS:
10 patients of terminal ill patients of urocancer were identified as spiritually motivated by FICA. Spiritual care was provided by doctors, paramedics and Nurses in form providing Quran, recitation of SuraYaseen, Sura Rahman, SuraFateha and AyatulKursi. Two patients requested for prayers from clergymen. The care oriented model of whole patient care showed positive aptitude of patients towards coping of disease and compliance with medication. Nvivo reveled ” I am very satisfied and relaxed after listening surayaseen” “Now I have no pain as recitation has relaxed me with blessing” “ I am comfortable going into other world O God u forgive me”. All the patients died peacefully and attendants were very satisfied with provision of spiritual care and not even a single patient ended up in complains or enquiry.
CONCLUSION:
The care oriented model is the call of the day from cure oriented model. The provision of spiritual; need of the patients helps significantly in coping and compliance of the patients.
KEY WORDS: Spirituality, Faith healing, end of life care