Palliative care needs and health seeking behavior of people in two rural districts of nepal: a house-to-house survey
Notice bibliographique
Résumé
BACKGROUND: Palliative care is integral to Universal Health Coverage. In Nepal 80% of the population live in rural often mountainous areas. Despite a national commitment to palliative care close to home, services in rural areas remain underdeveloped. We report on the palliative care needs and health seeking behaviour in two rural districts. METHODS: A cross-sectional house to house survey was conducted across four municipalities in two rural districts. People in need of palliative care were identified using the general indicators of Supportive and Palliative Care Indicators Tool for Low Income Settings (SPICT-LIS) and recruited. They were questioned about diagnosis and health seeking behaviour and also about symptoms and quality of life using the Nepali Palliative Care Outcome Scale (N-POS). For those unable to respond, the main carer was asked to provide data. Data were analyzed descriptively using MS Excel 2016. RESULTS: A total of 587 households with 2320 residents were surveyed. Fifty-eight (2.5%) were identified as needing palliative care, ranging from 0.8 to 3.4% between municipalities. Only one child was identified and excluded from this study because their needs are not comparable with adults. The median age of those requiring palliative care was 79 years (Range 21–98); 50% were female. Forty-four/58(76%) had a diagnosis of at least one chronic illness, including hypertension and diabetes, but in only 32/58 (55%) was this a condition potentially leading to palliative care need. Difficulty in walking (58/58;100%), weakness (56/58;97%) and pain (44/58;76%) were the most common physical complaints. Fifty-one/58(93%) reported at least one psychosocial or spiritual need. Of those with a chronic illness diagnosis, 25/44(57%) were receiving ongoing medical care: 16/25(64%) at tertiary hospitals and 5/25(20%) at a local community hospital. Although 41/58(71%) had enrolled in government health insurance, cost remained a commonly reported barrier to accessing health care. CONCLUSION: Significant numbers of adults with palliative need in rural Nepal exist with a high burden of physical, psychosocial and spiritual suffering. Those receiving follow up mainly travel to distant tertiary hospitals with local services being underutilized. Despite health insurance, costs prevented access to health care. Our findings are informing the development of a rural palliative care model for Nepal.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».