Atsede Fantahun Aregay

• Aregay, Atsede Fantahun; O'Connor, Margaret; Stow, Jill; Ayers, Nicola & Lee, Susan (2023). Perceptions of Barriers to Using Opioid Analgesics: A Mixed Methods Study. Palliative Medicine Reports (PMR). doi: 10.1089/pmr.2023.0021. Full text in Research Archive
• Aregay, Atsede Fantahun; O’Connor, Margaret; Stow, Jill; Ayers, Nicola & Lee, Susan (2023). Palliative care in Ethiopia’s rural and regional health care settings: a qualitative study of enabling factors and implementation challenges. BMC Palliative Care. ISSN 1472-684X. 22(1). doi: 10.1186/s12904-023-01283-5. Full text in Research Archive Show summary

  Background Palliative care is limited in Ethiopia, particularly in rural areas, where more than 78% of the population live. Current initiatives and research are focused on urban settings and are primarily donor dependent. This study aims to explore the status of palliative care, enabling factors and implementation challenges in Ethiopia’s rural and regional health care settings. Methods A qualitative regional case study was conducted with health professionals drawn from different health care settings, academic institutions and included health planners and practitioners. Focus groups were conducted with rural community members and face- to face- individual interviews were conducted with health professionals working in numerous roles as well as academic leaders. Results Participants indicated that despite a few leaders being aware of the inclusion of palliative care in the Ethiopia national policies and guidelines, palliative care is not, integrated into the existing health care system. Other participants responded that palliative care is not well integrated into the undergraduate and postgraduate courses except for limited content in the diploma and a few postgraduate courses. Participants described the challenges for palliative care implementation as follows: many lacked awareness about palliative care; and chronically ill patients other than those with HIV received inadequate care, limited to physical care, some pain management, and psychosocial support rather than comprehensive palliative care. In addition, some participants perceived that palliative care was not within the remit of their service, so families and patients were forced to seek alternative or informal care, including from traditional healers. Conclusions Enablers for the improvement of palliative care access in rural and regional health care were identified, including better integration of palliative care into the national health care plan and guidelines; palliative care content in university and college courses; and use of mobile phone technology to facilitate care. And policy makers and responsible stakeholders could consider the palliative care implementation in rural and regional health care settings through a combination of home, community and facility-based models.

• Aregay, Atsede Fantahun; O'Connor, Margaret; Stow, Jill; Ayers, Nicola & Lee, Susan (2023). Perceived policy-related barriers to palliative care implementation: a qualitative descriptive study. Palliative Care & Social Practice. 17. doi: 10.1177/26323524231198542. Full text in Research Archive Show summary

  Background: Ethiopia has a national palliative care guideline, and palliative care is explicitly recognised in the country’s healthcare policy and health sector transformation plans. However, palliative care is not fully delivered in the regional public hospitals and primary health care units.Objective: This study explores perceived policy barriers to deliver palliative care services in rural and regional healthcare settings, which primary healthcare units largely serve.Design: Face-to-face interviews were conducted in a rural region of Ethiopia.Methods: Forty-two participants were recruited from a variety of health settings including primary, secondary and tertiary levels across the region. Interviews were conducted with policymakers from the regional health bureau, pharmacists, medical doctors, health officers (clinical officers) and nurses, including chief nursing officers in leadership roles at all levels of healthcare institutions. Data analysed using thematic analysis.Results: Participants described several barriers related to healthcare policy, including lack of government priority and focus on palliative care; lack of health professionals’ awareness of the national palliative care plans and guidelines; and lack of palliative care integration into the existing healthcare system and the national budget. Participants remarked that palliative care services in the region were mainly limited to HIV patients, often managed with external support and, hence unsustainable.Conclusions: Policy priority and focus is a fundamental component for the provision of palliative care because lack of focus and support from the government have led to inadequate access to palliative care for all in need. Hence, as participants suggested, palliative care should be integrated into all healthcare levels, particularly into the primary health care units and the health extension programme, to facilitate health extension workers to support millions living in rural areas.

• Aregay, Atsede Fantahun; O'Connor, Margaret; Stow, Jill; Ayers, Nicola & Lee, Susan (2023). Measuring and exploring the barriers to translating palliative care knowledge into clinical practice in rural and regional health-care settings. Palliative & Supportive Care. ISSN 1478-9515. doi: 10.1017/S1478951523000755. Show summary

  Objectives. This study aims to measure and explore the barriers to translating theoretical knowledge of palliative care into clinical practice. Methods. A mixed-method study, combining a cross-sectional survey and key interviews was conducted. The quantitative data were obtained from 173 nurses and the key interviews were conducted with 42 health professionals drawn from multiple settings. For quantitative data analysis, Statistical Package for the Social Sciences software were conducted, and a thematic analysis supported with NVivo software were used for analyzing qualitative data. Results. Of the 220 nurses invited, 173 completed the survey (79%). Most (78%) had a bachelor’s degree in nursing. Fewer than half, 69 (40%) scored 75% or more for the knowledge test; 173 (100%) scored 50% or greater for attitude; and only 32 (18.5%) scored 75% or greater for self-reported practice. While there was a small, positive correlation between palliative care attitudes and self-reported practice (r = 0.22, p = 0.003), the qualitative findings indicated that nurses had significant challenges in translating their theoretical knowledge into clinical practice. Limited clinical practice was linked to inadequate knowledge resulting from insufficient integration of palliative care content in undergraduate curricula and a lack of follow-up training. This was further exacerbated by shortages of medicine, staff, and financial resources and was linked to limited attention accorded to palliative care by the government. Significance of results. While the results showed the majority held positive views toward palliative care, improving palliative care practices requires, and enhancing nurses’ knowledge of palliative care. This requires changing teaching methods and engaging policymakers.

View all works in Cristin