Psycho-spiritual challenges faced by palliative health care providers in Bangladesh: A multicenter-based descriptive cross-sectional study
Description
Background: Palliative care providers play a crucial role in supporting patients with life-limiting illnesses by emphasizing the alleviation of suffering and enhancing quality of life. The intrinsic nature of palliative care, which often involves confronting death and dying, places considerable emotional and spiritual demands on caregivers. Psycho-spirituality, an integration of psychological well-being and spiritual dimensions, is vital for these providers to maintain their mental health and provide holistic care to their patients. Despite its importance, empirical studies focusing on the psycho-spiritual experiences of palliative care providers are limited. Method: This multicenter-based, descriptive cross-sectional study aims to explore the psycho-spiritual challenges faced by palliative care providers. Data was collected from 160 licensed healthcare providers, through face-to-face semi-structured interviews conducted from August to September 2022. Result: The results indicate that younger healthcare providers (aged 20-39) report higher psychological stress compared to their older counterparts (p = 0.029). Males exhibited slightly higher stress levels than females (p = 0.036), and divorced individuals reported the highest stress levels (p = 0.01). Educational qualification (p = 0.017), and income levels (p = 0.001) showed significant correlations with spiritual status with higher educational attainment and income associated with better spiritual well-being. Doctors experienced higher psychological stress (p = 0.004) but also reported higher spiritual status compared to nurses and other healthcare workers. Conclusion: The findings depict significant associations between sociodemographic factors and the psychospiritual well-being of healthcare providers. Understanding these associations is crucial for developing targeted interventions to support the well-being of palliative care providers, ultimately leading to better patient care outcomes. Future research should focus on expanding the scope.
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Study design and settings, sample size, and criteria: This research was a descriptive cross-sectional study. It involved 160 participants selected using the census method from an estimated staff population of 178. Data collection occurred from August to September 2022. The study targeted licensed healthcare providers of both sexes, including doctors, nurses, palliative care assistants, ward staff, and PCAs. These participants had been providing palliative care for at least one year in various healthcare facilities in Dhaka city, Bangladesh. Providers who were physically or mentally unfit were excluded from the study. Data was gathered from BSMMU, Dhaka College & Hospital, Delta Medical College & Hospital, National Institute of Cancer Research Hospital, and community-based palliative care projects of BSMMU in collaboration with WHPCA in Korail and Narayanganj City Corporation. Field data was verified immediately post-interview. The sample size comprised 160 participants, chosen using the census method from an estimated population of 178 healthcare providers. The study included licensed healthcare providers of both sexes, specifically those who had been actively involved in palliative care for a minimum of one year. Exclusion criteria included any providers deemed physically or mentally unfit. Data collection process and analysis: Data collection involved face-to-face semi-structured interviews based on predetermined variables. The questionnaire was originally developed in English and then translated into Bangla. Interviews, conducted privately, lasted about 30 minutes each and participation was voluntary. Data processing involved categorizing, coding, summarizing, and entering data into SPSS software. Categorical and numerical variables, by using 5-point Likert scale, were treated separately: a "Never" or “completely disagree” response was scored as "0," a "Almost never" or “disagree” as "1," “Sometimes” or “Almost agree” as “2”, “Fairly often” or “Almost agree” as “3” and "Very often " or "Completely agree" as "4." Descriptive statistics were used for qualitative and quantitative variables, while inferential statistics were applied to determine relationships among variables.