Date of Award
11-14-2023
Document Type
Dissertation
Degree Name
Master of Science in Nursing (MScN)
First Supervisor/Advisor
Dr. Salma Rattani
Second Supervisor/Advisor
Ms. Zohra Kurji
Third Supervisor/Advisor
Dr. Atif Waqar
Department
School of Nursing and Midwifery, Pakistan
Abstract
Background: The growing significance of end-of-life care in response to the increasing prevalence of chronic illnesses and aging populations has prompted recognition of the need for patient-centred care. Care pathways are employed worldwide to offer comprehensive end-of-life care to patients in various healthcare settings. In Pakistan, there is a recognised need to evaluate the feasibility of introducing an end-of-life care pathway.
Objectives: This study aimed to (a) determine the feasibility of using an end-of-life care pathway for hospital-based and home-based palliative care patients, and (b) explore the experiences and opinions of registered nurses piloting the pathway.
Methods: An explanatory sequential mixed methodological approach was employed to investigate the feasibility of implementing an end-of-life care pathway. The quantitative phase involved the distribution of a structured survey to the registered nurses, gauging their perceptions of end-of-life care needs and preferences. For the qualitative phase, nurses who had used the pathway on their patients were invited for two focused group discussions. These FGDs captured contextual insights and explored factors influencing feasibility and were analysed thematically.
Results: The responses to the questionnaire were presented as frequencies and percentages. Each response was given a score to be compared against the feasibility criteria. Each criterion, patient safety (t=-12.9, p<0.0001), resource availability (t=5.9, p<0.0001), staff competence (t=2.8, p=0.02), collaborative approach (t=8.8, p=0.0001), ethical considerations (t= 8.4, p= 0.0002), patient and family acceptance (t=6.5, p=0.0005), outcome measurement (t=6.8, p= 0.0004), and scalability and sustainability (t=7.6, p=0.0001), had statistically significant scores. Thematic analysis of the FGDs identified six themes on the factors influencing end of life care.
Conclusion: This mixed methodological study provided a comprehensive exploration of the feasibility of an end-of-life care pathway, offering valuable insights for policymakers, healthcare professionals, and researchers involved in end-of-life care.
Recommended Citation
Mistry, N. A. (2023). A mixed methodological approach to study the feasibility of an end-of-life care pathway (Unpublished master's dissertation). Aga Khan University, Karachi, Pakistan.