Volume 23, Number 7: July 2022
IAHPC Scholars shared these reports after attending the online European Association for Palliative Care Conference in May. IAHPC Scholarships to other conferences are now available: see the News section for details.
How to Make Research Less Intrusive for Patients
Robai Gakunga, population health research scientist
Nairobi, Kenya
Meetings like the EAPC Research Congress are important avenues to keep up to date with research, which is dynamic, and to build networks.
We need to engage with stakeholders (patients, their relatives, medical caregivers, policy makers, etc.) at the start of projects in order to understand the issues that are important to them. Resources, which are scarce, should be directed to research where findings will be useful.
I have felt awkward sometimes when collecting data from people who are ill, as this is a time when patients need time alone or with those close to them without being burdened with questionnaires and bedside interviews. Dr. Lucas Morin (France) and Dr. Tobias Steigleder (Germany) offered some solutions:
- Minimally intrusive portable/wearable devices and patches that can collect lots of data within seconds are now affordable.
- Radar-based sensing technology systems can be used under the mattress to estimate prognosis, which would guide treatment planning.
- Apps on mobile phones/tablets can be used to monitor compliance as well as the effects and side effects of medication in order to guide palliative care teams on home visits.
Dr. Steigleder emphasized that—even with these kinds of technological advancements—research must not interfere with the need for the social interaction and personal care that are core to palliative care.
Big data (routinely collected clinical practice data, administrative registry data, and health care claims data) can be used to overcome the difficulty of recruiting and retaining participants in palliative care research. However, it comes with quality issues and absence of information that really matters to patients, such as their experiences and quality of life measurements. Also, big data does not come in the usual structured formats and tables. It needs to be carefully reorganized (data wrangling) before analysis.
Dr. Morin summarized that the use of big data for research “will make a difference if we can leverage high quality information to ask questions that matter in order to provide answers that are useful.”
European Conference Topics Were Relevant to Uganda
Antonia Kamate Tukundane, site programs manager, Mobile Hospice Mbarara
Mbarara, Uganda
The three days away from my routine duties to be able to focus on the online plenary and abstract presentation sessions has been a priceless experience: I have been exposed to so many developments in palliative care that I did not know about.
Dr. David Currow’s opening presentation “What Can We Learn from Conducting Controlled Clinical Trials in Palliative Care?” challenged me to think about whether we are paying due attention to issues of standards in our palliative care practice. He spoke about the critical need for palliative care practitioners and administrators to continuously seek new knowledge and not stick to what we have always known.
These are our main challenges as we work to implement palliative care in Uganda:
- Very few physicians and general practitioners are interested in palliative care, stifling advocacy. Doctors are the best people to convert other doctors to support palliative care.
- Limited research is going on to figure out how to improve our local pain assessment and palliative care management practices.
- Many people in the community think that receiving palliative care means hastened death, which is not true. Palliative care is all about improving quality of life.
- There is a huge knowledge gap among health care practitioners regarding palliative care, including doctors, nurses, physiotherapists, etc.
- Other professionals—such as social workers, spiritual leaders, occupational therapists, etc.—need to support the provision of quality palliative care.
The main thing to do to overcome these barriers is to disseminate knowledge. The second thing is to act on this knowledge by using it to advocate for what is right for the patient and family. I want to share the relevant presentations with coworkers, hoping to stir up the conversation about standards and help us begin to change the way we work.
The main regional referral hospital a few kilometers away depends on us to provide palliative care, but our small team cannot handle the need. My plan is to make a presentation to pediatric oncology nurses and doctors on pain assessment and management, to help open the team up to consider building their own capacity to assess and manage pain.
‘It Enlarged the Scope of How I Think about Palliative Care’
Mobashshar Hassan, MD, palliative medicine specialist, Senkatana Oncology Clinic
Maseru, Lesotho
Providing palliative care to cancer patients and their relatives is my daily job at the cancer clinic in Lesotho. At the conference, sessions featuring champions of palliative care shared recent learning that I will be able to integrate in my practice.
It was informative and helpful: it enlarged the scope of how I think about palliative care for patients facing life-threatening illnesses and their relatives.
‘Knowledge Gained Has Inspired Me’ To Reach Further
Dorothy Adong Olet, MD, academic program coordinator, Hospice Africa Uganda
Kampala, Uganda
This congress exposed me to the state-of-art research in palliative care. I gained knowledge about how clinical trials have been successfully conducted in various European countries, and learned better how research is important to improve evidence for clinical palliative care. There are no standards for palliative care; research can guide clinicians to change their practice over time.
The congress highlighted palliative care during the humanitarian crisis in Ukraine. It called for more individualized and personalized care.
I learned about the role of innovative technology, which can monitor vitals that can lead to congregate data. The technology-driven data gathered can be made available, accessible, and usable with technology that incorporates a specific biomarker, such as how breathing changes when opioids are used.
Knowledge that I have gained at the congress has inspired me to:
- conduct research to improve palliative care delivery at Hospice Africa Uganda,
- advocate for palliative care for those in need,
- train health care professionals as well as palliative care students, and
- mentor students undertaking research.
‘I Learned about Usage of Opioids in Treating Cancer’
Koffi Amoumou Tengué, director-general, ORJEDEC (Organisation Jeunesse pour le Développmenent Communitaire)
Tabligbo, Togo
The congress showed me the extent to which patients are suffering in humanitarian crises, and how difficult the provision of palliative care can be for caregivers and researchers. I also learned about the usage of opioids in treating cancer. I was glad to be given the opportunity to meet other providers of palliative care services in different countries.
I Feel Less Like an Isolated Researcher and My Skills Are Sharpened
Christine February, acting department head, Undergraduate Nursing Science, Western Cape College of Nursing
Cape Town, South Africa
This meeting was very beneficial for my research networking. COVID-19 has made social networking possible on a large and more efficient scale; the conference has made me fell less of a lonely, isolated researcher. I have also been empowered to present at such an important conference in the future.
Palliative care is my specialty, and learning new, updated information on an international level was very important: it both challenged and sharpened my palliative care skills. I will definitely implement the information in my classes at the undergraduate teaching program at the nursing college. In addition, I am working nationally to implement palliative care guidelines for all categories of staff, as well as serving on the research board.