Factors affecting development of palliative care

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PostSweethoney on 2nd November 2012, 4:08 pm

1. Social influence
Poverty in the society that hinders voluntary services, cultural language and security problems, and a growing Aids population, have been observed to constitute a great influence to palliative care in Africa and other third world continents (Field and Cassel, 1997). In both rich and poor countries, palliative care involves competition for money and resources with child and material care, or means to keep the working population fit and healthy (Ford, 1994). This is a struggle that involves ethical, practical and political choices for resources allocated to health.

However, courtiers with relatively plentiful resources are better off as poor countries may not have money for drugs, equipments or such simple necessities as beds and blankets. And whatever resources that is available may well be directed to defined public health priorities. In rural Africa and Colombia for example, great distance and poor transport system compound the lack of trained personernel for home care, compared to Australia and Britain where full time, part part time and even volunteer staff provide cover in remote country sides ‘Availability of volunteers is an indicator of a prosperous and stable community where social and religious charitable groups can be self- sustained to render palliative care services ‘’(Ford, 1994) Ethnic Influence
Religious and ethnic considerations form of palliative care in any community. Kenya for instance is known to utilize mostly traditional healers among patients. A respondent comment from Singapore in ford (1994) shows that multi-language situation, different religious practices, and tradition inform some references to hospices as “death houses and palliative health workers as “angels of death” countries like Germany and Switzerland confuse palliative care with euthanasia (ford in Doyle, Hanks and Mc Donald (1994).
African and Asian societies’ concept and rituals of death is a barrier to palliative care. Here there are formal and informal taboos that inhibit plain spacing and dealing or acceptance of death which is chrematistics of palliative care. The nurse thus cannot give terminal care and counseling, for religious and psychosocial reasons but is only limited to essentials of pain control and nursing.
However, in some societies, Christianity has to some extent robbed this off and promoted the development of palliative nursing

Professional influence:
The medical profession traditionally has an established hiecrarch and inters – disciplinary professional term – work without any district system based body of knowledge, contrast with traditional medical emphasis on curative and heroic measure to sustain life. Specialist division of medical practice, which provide room for promotion, special intervention like operations, diagnostic tests and body examination ridiculed the idea of good financial reward to a specialist who is taking care of a terminally ill-patients to whom no active treatment is planned. There are of course professional and emotional satisfactions in helping patients and families to cope with impending death, but it is not same as financial in centives. Hence, it is not attractive and easy to recruit nurses into the area (ford in Doyle et al 1994).
Further, the enhanced role of nurses in palliative care doctors and nurses in general and the palliative care nurse who is intimately associated to the dying patient and his family. The nurse spends more time counseling and caring for the patient in contrast to the snapshot visit of the doctors, therefore creating what a New Zealand report termed jealous attitude by some members of the public nursing services thereby projecting hospice nurses as competitors for public founds and status. This jealously according to report from Hong-Kong informs why home care nurses get little support from doctors and other professionals (Ford, 1994).

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