Evidence map›Paper›PMID 27059019›Full record

ArticleBMC palliative care2016

A palliative care link nurse programme in Mulago Hospital, Uganda: an evaluation using mixed methods.

Julia Downing, Mwazi Batuli, Grace Kivumbi, Josephine Kabahweza, Liz Grant, Scott A Murray, Elizabeth Namukwaya, Mhoira Leng

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In one paragraph

Article in BMC palliative care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Can You Hear Us Now? Equity in Global Advocacy for Palliative Care.Journal of pain and symptom management · 2022
    Article
  12. Article
  13. Article
  14. Article
  15. Infection control link nurses in acute care hospitals: a scoping review.Antimicrobial resistance and infection control · 2019
    Article
  16. Article
  17. Paediatric Palliative Care in Resource-Poor Countries.Children (Basel, Switzerland) · 2018
    Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Julia DowningMakerere University, PO Box 7757, Kampala, Uganda. julia.downing792@btinternet.com.
Mwazi BatuliMakerere Palliative Care Unit, PO Box 7757, Kampala, Uganda.
Grace KivumbiMakerere Palliative Care Unit, PO Box 7757, Kampala, Uganda.
Josephine KabahwezaMulago Hospital, PO Box 7757, Kampala, Uganda.
Liz GrantGlobal Health Academy, Centre for Population Health Sciences, University of Edinburgh. Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
Scott A MurraySt. Columba's Hospice Chair of Primary Palliative Care, Primary Palliative Care Research Group, University of Edinburgh, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
Elizabeth NamukwayaMakerere University, PO Box 7757, Kampala, Uganda.
Mhoira LengMakerere University, PO Box 7757, Kampala, Uganda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntegrating palliative care (PC) and empowering the health care workforce is essential to achieve universal access to PC services. In 2010, 46% of patients in Mulago Hospital, Uganda had a life limiting illness, of whom 96% had PC needs. The university/hospital specialist PC unit (Makerere/Mulago Palliative Care Unit -MPCU) implemented a link-nurse model to empower hospital nurses to provide generalist PC. Over two years, 27 link nurses were trained and mentored and 11 clinical protocols developed. The aim of the study was to evaluate the impact of the palliative care link nurse programme at Mulago Hospital

methodsAn evaluation approach utilising mixed methods was used integrating qualitative and quantitative data including: pre and post course assessment confidence ratings; course evaluation forms; audit of clinical guidelines availability; review of link-nurse activity sheets/action plans; review of MPCU patient documentation; Most Significant Change (MSC); individual and focus group interviews.

resultsA significant difference was seen in nurses' confidence after the training (p < 0.001). From July 2012 to December 2013, link nurses identified 2447 patients needing PC, of whom they cared for 2113 (86%) and referred 334 (14%) to MPCU. Clinical guidelines/protocols were utilised in 50% of wards. Main themes identified include: change in attitude; developing new skills and knowledge; change in relationships; improved outcomes of care, along with the challenges that they experienced in integrating PC. Since the start of the programme there has been an increase in PC patients seen at the hospital (611 in 2011 to 1788 in 2013).

conclusionThe link-nurse programme is a practical model for integrating PC into generalist services. Recommendations have been made for ongoing development and expansion of the programme as an effective health systems strengthening approach in similar healthcare contexts, as well as the improvement in medical and nursing education.

Indexed as

Program EvaluationAdultCommunity NetworksEducation, ContinuingFemaleFocus GroupsHealth Services Needs and DemandHumansMaleMiddle AgedNursesPalliative CareQualitative ResearchSurveys and QuestionnairesUgandaAfricaEducationEvaluationGeneralist palliative careHospitalMixed methodsNursesPalliative careService deliveryUganda

Identifiers

PMID27059019
PMCPMC4825074

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.