ArticleAfrican journal of primary health care & family medicine2014
Where there is no morphine: the challenge and hope of palliative care delivery in Tanzania.
Article in African journal of primary health care & family medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 21 citations in OpenAlex.
- mPalliative Care Link: Examination of a Mobile Solution to Palliative Care Coordination Among Tanzanian Patients With Cancer.JCO global oncology · 2021Trial
- Community-based palliative care needs and barriers to access among cancer patients in rural north India: a Participatory action research.BMC palliative care · 2024Article
- Community health workers in palliative care provision in low-income and middle-income countries: a systematic scoping review of the literature.BMJ global health · 2020Article
- Forging a New Frontier: Providing Palliative Care to People With Cancer in Rural and Remote Areas.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Review
- Qualitative Analysis of Palliative Care for Pediatric Patients With Cancer at Bugando Medical Center: An Evaluation of Barriers to Providing End-of-Life Care in a Resource-Limited Setting.Journal of global oncology · 2018Article
- What is the value of palliative care provision in low-resource settings?BMJ global health · 2017Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundIn Tanzania, a country of 42 million, access to oral morphine is rare.
aimTo demonstrate the effectiveness of palliative care teams in reducing patients' pain and in increasing other positive life qualities in the absence of morphine; and to document the psychological burden experienced by their clinical providers, trained in morphine delivery, as they observed their patients suffering and in extreme pain.
settingOne hundred and forty-fie cancer patients were included from 13 rural hospitals spread across Tanzania.
methodA mixed method study beginning with a retrospective quantitative analysis of cancer patients who were administered the APCA African POS tool four times. Bivariate analyses of the scores at time one and four were compared across the domains. The qualitative arm included an analysis of interviews with six nurses, each with more than fie years' palliative care experience and no access to strong opioids.
resultsPatients and their family caregivers identifid statistically signifiant (p < 0.001) improvements in all of the domains. Thematic analysis of nurse interviews described the patient and family benefis from palliative care but also their great distress when 'bad cases' arose who would likely benefi only from oral morphine.
conclusionPeople living with chronic cancer-related pain who receive palliative care experience profound physical, spiritual and emotional benefis even without oral morphine. These results demonstrate the need for continued advocacy to increase the availability of oral morphine in these settings in addition to palliative care services.
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