Includes bibliographical references. / Palliative care, for those dying from a life-threatening disease, has developed to become a definite discipline in mostly developed countries. Through this palliative care has become accepted as a human right to all in need of end-of-life care. The stark reality in developing countries is that palliative care is in the early stages of development, with the result that if it is available at all, it usually is very basic. These countries which have restricted resources available are faced with an increased and overwhelming demand for palliative care because of the AIDS pandemic and also an expected massive increase in the incidence of cancer and non-communicable diseases. This raises the question how this demand will be met? The WHO is again looking at primary care as the way of meeting increased health care demands, including palliative care. The importance of the role of the general practitioner in delivering palliative care is widely accepted. The greatest majority of general practitioners in South Africa have never received official palliative care training. The question to be answered then is how well are they equipped to meet this increasing demand for end-of-life care. The study was designed as a descriptive cross-sectional KABP study. The study population was defined as all practising GPs working in a particular area in the northern suburbs of Cape Town and a number of Boland towns. The data collection tool used was a self-administered questionnaire that was developed through a process of review and through a pilot process. The questionnaire was then posted to all identified GPs with a return envelope with follow-up of non-respondents to ensure a better response rate. The response rate was 34,7%. Overall 69,45% of the questions were answered correctly and 30,55% incorrectly. The respondents showed good knowledge on morphine use and respiratory depression, the dangers of addiction to morphine, emergencies in palliative care and spinal cord compression. The greatest majority of respondents do not understand the holistic approach to pain management and also do not have knowledge about the use of syringe drivers. A high percentage of participants have a positive attitude towards palliative care in general, feel comfortable with their own emotions in end-of-life care and acknowledge their need for further training. On the questions on belief, respondents believe that the family must be involved in decision-making and that the GP must be doing bereavement care. Unfortunately most participants believe the management of physical symptoms ensures quality of life and seem not to grasp the holistic approach followed in palliative care. In practice only a few respondents understand the routine use of anti-emetics with initial opioid prescriptions. There is a significant number of GPs uncertain about the use of combinations of analgesics, the use of intravenous fluids in end-of-life care and the use of the subcutaneous route to administer drugs and fluids. The importance of the role of the GP in palliative care has to be recognized and acknowledged by all involved in such care. Programmes have to be initiated to train and educate practising GPs in palliative care to empower them and also to spread the end-of-life care message.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uct/oai:localhost:11427/11632 |
| Date | January 2012 |
| Creators | Loftus, Cornelius |
| Contributors | Gwyther, Liz |
| Publisher | University of Cape Town, Faculty of Health Sciences, Department of Public Health and Family Medicine |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Master Thesis, Masters, MPhil |
| Format | application/pdf |
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