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Introduction <p>Although palliative care (PC) is recognized as a component of comprehensive care throughout the life course and universal health coverage, more than 85% of the global need for PC is unmet. Nigeria has isolated PC provision, with a narrow scope, limited availability, and inadequate support for PC services, despite having adequate legislation to support the operation in the country. Given the rising incidence of chronic illnesses that are amenable to PC in Nigeria, this study aimed to explore healthcare professionals’ (HCPs’) knowledge and attitudes towards PC and identify targets for improving PC delivery nationally.</p> Methods <p>Using a mixed-methods convergent design, an online survey was distributed to multidisciplinary HCPs in Nigeria. The survey included validated tools that assessed knowledge and attitudes related to PC, pain management, and end-of-life (EOL) care. Five focus group discussions (FGDs) were conducted and qualitatively analyzed using rapid matrix analysis to triangulate themes with survey responses.</p> Results <p>From February to December 2024, 117 HCPs from 26 hospitals across five of six geopolitical zones of Nigeria completed the quantitative survey. Most respondents were nurses (67%) or physicians (26%), worked in public teaching hospitals (70%), and provided care for patients with cancer (94%). Over half (56%) received some PC training, though many expressed interest in additional training on pain management (65%), EOL communication skills (50%), and EOL ethics and decision-making (49%). FGDs from three geopolitical zones revealed 3 major themes: (1) HCPs have a shared high-level understanding of the goals of PC with varied perceptions around PC delivery; (2) Challenges in the practical delivery of PC include systemic barriers, opioid costs and stigma, and patient receptivity; (3) Delivering PC impacts HCPs’ job satisfaction and takes a psychological toll. Participant-identified strategies for overcoming barriers to PC delivery included the development of standardized PC protocols, opioid policy changes, patient education about PC, and HCP training and support.</p> Conclusion <p>HCPs in this study demonstrated broad interest in and knowledge about PC. However, systemic barriers and limited patient and caregiver receptivity limit PC uptake in clinical practice. Future initiatives should involve clinical training related to PC communication, community education programs, and implementation of contextually appropriate protocols and policies for PC delivery.</p>

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“What you don’t have, you can’t give”: a mixed methods assessment of healthcare professionals’ palliative care knowledge and attitudes in Nigeria

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  • 出版模式：

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  • 发表日期：

    2026年5月26日

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  • Sharif Folorunso,
  • Betel Yibrehu,
  • Erica J. Mann,
  • Catherine N. Zivanov,
  • Jaime Gilliland,
  • Faith S. Fasakin,
  • Matthew J. Allsop,
  • Temidayo Avwioro,
  • Chinenye Iwuju,
  • Dalhat Khalid,
  • Ejikeme O. Nwachuku,
  • Israel A. Owoade,
  • Folaju O. Oyebola,
  • T. Peter Kingham,
  • Olusegun I. Alatise,
  • William E. Rosa

摘要

Introduction

Although palliative care (PC) is recognized as a component of comprehensive care throughout the life course and universal health coverage, more than 85% of the global need for PC is unmet. Nigeria has isolated PC provision, with a narrow scope, limited availability, and inadequate support for PC services, despite having adequate legislation to support the operation in the country. Given the rising incidence of chronic illnesses that are amenable to PC in Nigeria, this study aimed to explore healthcare professionals’ (HCPs’) knowledge and attitudes towards PC and identify targets for improving PC delivery nationally.

Methods

Using a mixed-methods convergent design, an online survey was distributed to multidisciplinary HCPs in Nigeria. The survey included validated tools that assessed knowledge and attitudes related to PC, pain management, and end-of-life (EOL) care. Five focus group discussions (FGDs) were conducted and qualitatively analyzed using rapid matrix analysis to triangulate themes with survey responses.

Results

From February to December 2024, 117 HCPs from 26 hospitals across five of six geopolitical zones of Nigeria completed the quantitative survey. Most respondents were nurses (67%) or physicians (26%), worked in public teaching hospitals (70%), and provided care for patients with cancer (94%). Over half (56%) received some PC training, though many expressed interest in additional training on pain management (65%), EOL communication skills (50%), and EOL ethics and decision-making (49%). FGDs from three geopolitical zones revealed 3 major themes: (1) HCPs have a shared high-level understanding of the goals of PC with varied perceptions around PC delivery; (2) Challenges in the practical delivery of PC include systemic barriers, opioid costs and stigma, and patient receptivity; (3) Delivering PC impacts HCPs’ job satisfaction and takes a psychological toll. Participant-identified strategies for overcoming barriers to PC delivery included the development of standardized PC protocols, opioid policy changes, patient education about PC, and HCP training and support.

Conclusion

HCPs in this study demonstrated broad interest in and knowledge about PC. However, systemic barriers and limited patient and caregiver receptivity limit PC uptake in clinical practice. Future initiatives should involve clinical training related to PC communication, community education programs, and implementation of contextually appropriate protocols and policies for PC delivery.