Pattern of Admissions and Needs Assessment for Palliative Care Services Among in-patients in a Tertiary Health Facility in South-Western Nigeria

Abstract

Abstract BACKGROUND Palliative care development emphasizes educationand medication availability. Only 12% of needs for palliative care are met. Palliative care domains and experience of patientsand their families are vital in life-limiting conditions. The Lagos University Teaching Hospital (LUTH), possess the National Cancer Centre but currently has no palliative care unit. AIM The aim was to examine pattern of admissions and needs assessment for palliative services among patients admitted into LUTH wards. METHOD The survey was conducted using a cross-sectional design to recruit 129 consecutive respondents. Together for Short Lives (TfSL) tool was used to categorize respondents’ conditions into Palliative and Non-palliative conditions. Information on diagnosis, stage of disease, domains of palliative care, advance care plan, preparation for home care, death and education about the illness was retrieved. Descriptive characteristics of the participants were presented as frequencies and percentages and Chi-squared test was used to determine association between the variables. Data analysis was done using Epi info version 7.2. RESULTS 80.6% of the respondents had palliative care conditions, 83.7% had family members as their caregiverwhile 13.2% of the participants had no care-giver and 65.9% had no advance care plan. There was no preparation for home care or death in 72.1% while 70.5% had education about their illnessand 68.2% were in the advanced stage of their disease. Participants attending the surgery non-trauma unit(51.6%) were more likely to have advance plans. Adults were more likely to have palliative care conditions (79.8%) compared to children (20.2%), and was statistically significant. CONCLUSION Majority of the participants need palliative care services but are unmet and the most predominant condition was cancer. Majority had no advance plan or preparation for home careor death despite having advanced stages of disease.This survey emphasizes the need for symptom management, communication and provision of support.