Covid-19 Front-Liners: Experiences of Palliative Care Providers in a Tertiary Hospital.

Introduction: In "normal" times, palliative care (PC) service delivery is confronted with many challenges thereby making access to care difficult. Now, we are in the era of COVID-19 where the healthcare ecology is radically changed. During this process of radical transformation, there are some ramification of COVID-19 on PC service delivery. Yet, there is a paucity of empirical evidence to support this claim. Objective: We explored PC providers' perspectives on delivering PC services in the era of COVID-19. Methods: Using an exploratory descriptive qualitative approach, we conducted face-to-face and telephone interviews with seven PC service providers at Korle Bu Teaching Hospital, Ghana. Haase's adaptation of Colaizzi's method was employed as the analysis strategy. Results: Two main themes emerged: ramifications and adaptations. The ramifications of COVID-19 on PC service delivery included changes in care relationship, perceived increased responsibilities, psychological distress, shortage of medicines, and treatment delays. In an attempt to mitigate the challenges posed by COVID-19 on PC service delivery, the following mechanisms adaptations were made: halting of service provision, resorting to tele-consultation, adopting shift system and reducing number of appointments, and adoption of infection prevention and control strategies. Conclusions: Our results indicate that COVID-19 has substantial ramification of PC service delivery. In conclusion, priority should be given to the training of healthcare workers on emergency preparedness for future pandemics. Also, continuous professional development would be needed in order build PC service providers' skills and capacity to effectively utilize tele-consultation in PC service delivery.