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A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town
Introduction: The Palliative Care needs of patients with Drug-Resistant Tuberculosis (DR-TB) are under-researched, yet pertinent in the management and control of DR-TB. Most literature reviewed focused on treatment schedules, outcomes, transmission, drug adherence, drug side effects and further drug...
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| Format: | Thesis |
| Language: | English |
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Division of Family Medicine
2019
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| _version_ | 1867613269485682688 |
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| access_status_str | Open Access |
| author | Odell, Shannon |
| author2 | Krause, René |
| author_browse | Krause, René Odell, Shannon |
| author_facet | Krause, René Odell, Shannon |
| author_sort | Odell, Shannon |
| collection | Thesis |
| description | Introduction: The Palliative Care needs of patients with Drug-Resistant Tuberculosis (DR-TB) are under-researched, yet pertinent in the management and control of DR-TB. Most literature reviewed focused on treatment schedules, outcomes, transmission, drug adherence, drug side effects and further drug-resistance. Aim: The aim was to determine the palliative care needs of patients infected with DR-TB living in the Southern sub-district of Cape Town. The Objectives The objectives were to determine the quality of life and symptom burden of DR-TB patients and to assess for correlation between these variables and palliative care needs. Methodology: In this cross-sectional study, twenty-eight participants were posed a culturally sensitive questionnaire designed by the researcher, that comprised: demographic questions, Likert-type questions for the African Palliative Care Association – Palliative Outcome Score (APCA-POS) tool, Eastern Co-operative Oncology Group (ECOG) score, a symptom checklist and open patient dignity questions. Quantitative and qualitative data of the respondents’ quality of life, functional status and burden of symptoms in the preceding week were ascertained. Pre-determined numerical scores in the Likert-type questions were deemed indicative of palliative care need. Results: Quantitative and qualitative analysis of the data showed that each participant had a palliative care need: be it either (or a combination of) unmet clinical, psychological, social and/or spiritual needs - despite being at differing stages of the DR-TB disease trajectory. These needs required contextualizing within the respondents’ communities where socio-economic issues were prevalent. Predominant physical complaints were tiredness (79%), joint pain (64%), confusion (61%) and shortness of breath (51%). Respondents’ also experienced a loss of autonomy, poor self-value and financial insecurity. Fifty percent of patients interviewed required urgent further management and referral to the local clinic. Conclusion: Despite the small cohort of patients and possible recruitment bias, this research concurred that a palliative care approach be adopted from the point of DR-TB diagnosis and throughout the treatment period – regardless of treatment outcome; and that DR-TB patients had significant unmet palliative care needs that affected their quality of life, functional status and dignity, regardless of whether pain was present. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/29700 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:26.520Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Division of Family Medicine |
| publisherStr | Division of Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/29700 A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town Odell, Shannon Krause, René Gwyther, Liz Palliative Medicine Introduction: The Palliative Care needs of patients with Drug-Resistant Tuberculosis (DR-TB) are under-researched, yet pertinent in the management and control of DR-TB. Most literature reviewed focused on treatment schedules, outcomes, transmission, drug adherence, drug side effects and further drug-resistance. Aim: The aim was to determine the palliative care needs of patients infected with DR-TB living in the Southern sub-district of Cape Town. The Objectives The objectives were to determine the quality of life and symptom burden of DR-TB patients and to assess for correlation between these variables and palliative care needs. Methodology: In this cross-sectional study, twenty-eight participants were posed a culturally sensitive questionnaire designed by the researcher, that comprised: demographic questions, Likert-type questions for the African Palliative Care Association – Palliative Outcome Score (APCA-POS) tool, Eastern Co-operative Oncology Group (ECOG) score, a symptom checklist and open patient dignity questions. Quantitative and qualitative data of the respondents’ quality of life, functional status and burden of symptoms in the preceding week were ascertained. Pre-determined numerical scores in the Likert-type questions were deemed indicative of palliative care need. Results: Quantitative and qualitative analysis of the data showed that each participant had a palliative care need: be it either (or a combination of) unmet clinical, psychological, social and/or spiritual needs - despite being at differing stages of the DR-TB disease trajectory. These needs required contextualizing within the respondents’ communities where socio-economic issues were prevalent. Predominant physical complaints were tiredness (79%), joint pain (64%), confusion (61%) and shortness of breath (51%). Respondents’ also experienced a loss of autonomy, poor self-value and financial insecurity. Fifty percent of patients interviewed required urgent further management and referral to the local clinic. Conclusion: Despite the small cohort of patients and possible recruitment bias, this research concurred that a palliative care approach be adopted from the point of DR-TB diagnosis and throughout the treatment period – regardless of treatment outcome; and that DR-TB patients had significant unmet palliative care needs that affected their quality of life, functional status and dignity, regardless of whether pain was present. 2019-02-19T13:54:30Z 2019-02-19T13:54:30Z 2018 2019-02-19T08:33:17Z Master Thesis Masters MPhil http://hdl.handle.net/11427/29700 eng application/pdf Division of Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | Palliative Medicine Odell, Shannon A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| thesis_degree_str | Master's |
| title | A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| title_full | A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| title_fullStr | A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| title_full_unstemmed | A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| title_short | A study to determine the palliative care needs of patients with drug resistant tuberculosis in the Southern sub-district of Cape Town |
| title_sort | study to determine the palliative care needs of patients with drug resistant tuberculosis in the southern sub district of cape town |
| topic | Palliative Medicine |
| url | http://hdl.handle.net/11427/29700 |
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