Placing care: the impact of the physical environment on experiences of providing and utilizing palliative care
Affiliation
University of BedfordshireUniversity of Dundee
University of Nigeria
Regent College, London
Issue Date
2022-08-05
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Environmental design in palliative and end-of-life care is known to improve care outcomes, service-user satisfaction, and the continuation of service uptake. No study in the literature has investigated the influence of the environment on palliative and end-of-life care in Nigeria or other African contexts. This study was designed to explore the impact of the physical environment (i.e., place and people) on staff and service users and how these influence the experiences of providing and using palliative and end-of-life care in a Nigerian hospital context. Ethnographic methodology was employed because this approach facilitates understanding of environmental realities. This study is part of a larger ethnographic research project developed to uncover aspects of organizational complexities related to the provision and use of palliative and end-of-life care in the Nigerian context. Three hundred fifty hours of participant observation was achieved, and semistructured interviews were used to gather data from 26 participants, including 10 patients, 11 members of a palliative care team, and five hospital managers. Informal chats and photographic capture were additional methods used in data collection. Thematic analysis was conducted to identify and analyze patterns within the collected data. Physical space, equipment, and placing staff were the three primary themes identified. The physical environment was untidy, and the ward layout prevented privacy, dignity, or comfort for patients and families. The equipment was old and inadequate, and the context of care was worsened by insufficient staffing and neglect of the environmental needs of the staff. Hospital design for palliative and end-of-life care in Nigeria is "autoinhibitory" (a negative feedback mechanism whereby hospital design detracts rather than promote quality of care), and a physical environment that supports the provision and utilization of care must be implemented to promote palliative and end-of-life care success. Urgent policy action is needed to improve environmental and staffing conditions to advance palliative and end-of-life care in Nigeria.Citation
Agom DA, Sixsmith J, Ominyi J, Onyeka TC, Agom JC (2022) 'Placing care: the impact of the physical environment on experiences of providing and utilizing palliative care', Journal of Nursing Research, 30 (5) e237Publisher
Lippincott, Williams & WilkinsJournal
Journal of Nursing ResearchPubMed ID
35939794Additional Links
https://journals.lww.com/jnr-twna/Fulltext/9900/Placing_Care__The_Impact_of_the_Physical.23.aspxType
ArticleLanguage
enISSN
1682-3141EISSN
1948-965Xae974a485f413a2113503eed53cd6c53
10.1097/jnr.0000000000000508
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- Creative Commons
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