Palliative care for people living with HIV/AIDS: Factors influencing healthcare workers’ knowledge, attitude and practice in public health facilities, Abuja, Nigeria

Abstract

AbstractPhysicians, nurses and allied health staff play very vital roles in addressing palliative care (PC) needs of people living with HIV/AIDS (PLWHA). The healthcare professionals’ experiences determine the success of palliative care delivery. There is paucity of data on palliative care for PLWHA. For this reason, we assessed the knowledge, attitude and practice of palliative care for PLWHA and associated factors among health care professionals.We conducted a cross-sectional descriptive study among healthcare workers (HCWs) in public health facilities in the Federal Capital Territory, Nigeria between February and May, 2017. Multistage sampling technique with proportionate-to-size allocation was used to determine facility sample size and HCWs per professional discipline. Data were collected with questionnaires adapted from Palliative Care Quiz for Nursing, Frommelt Attitude toward Care of the Dying and practical questions adapted from PC standard guidelines. Univariate analysis was done to compute frequencies and proportions. Odd’s ratios were calculated to assess the statistical association between variables and P-value ≤ 0.05 was considered significant. Multivariate analysis was conducted on variables that were significant with bivariate analysis. Epi-Info software was used for statistical analyses.The mean age of the 348 participants was 37.5 years (SD: ±8.9) and 201 (57.8%) were female. Thirty-six (10.3%) participants had good knowledge, 344 (98.9%) had favourable attitude and 90 (25.9%) had good practice of PC for PLWHA. Major determinants of good knowledge of PC include being a doctor (aOR = 2.70; 95%CI: 1.28 - 5.56). Determinants of good practice of palliative care include possessing a minimum of a bachelor degree (aOR=2.30; 95%CI : 1.05-5.08) and practicing in a tertiary hospital (aOR=6.67; 95%CI : 3.57-12.5).HCWs had favourable attitude towards PC for PLWHA despite an overall poor knowledge and practice. We recommended quality in-service training and continuous education on palliative care for HCWs.