Exploring the perspectives of nurses, physicians, and healthcare administrators in Saudi Arabian hospitals on palliative care and palliative care nursing

Almobarak, Fhaied Khalaf (2016) Exploring the perspectives of nurses, physicians, and healthcare administrators in Saudi Arabian hospitals on palliative care and palliative care nursing. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

This thesis presents a qualitative research study, which identifies issues regarding the development of palliative care in the Kingdom of Saudi Arabia (KSA) hospital setting, from the perceptions of healthcare professionals working in Saudi Arabian hospitals. The literature suggests that challenges to palliative care in KSA exist on various levels. At the professional level, they exist where healthcare practitioners may neither be sufficiently equipped nor sufficiently oriented to deal with palliative care concerns. Saudi practitioners may have misconceptions that lead them to recommend or carry out activities that may be detrimental to the palliative care of their patient. Issues also exist at institutional levels, where palliative care systems in place in Saudi hospitals are insufficient for addressing the needs of its patients. There are also issues found at the cultural and legal levels, where pain and individual choice are not considered sufficiently important in Islamic law especially when weighed against matters about prolonging and preserving life and preparing the individual for the afterlife. The aims of this study were to determine the perceptions of KSA hospital healthcare professionals regarding palliative care, identify issues regarding the development of palliative care in the KSA hospital setting and to develop recommendations for strengthening the value of palliative care among healthcare professionals in KSA. To this end, semi-structured qualitative interviews were carried out with members of staff working in hospitals in KSA, with terminally ill patients. The findings suggest that while some participants define palliative care in a way which is in keeping with internationally recognised definitions, others had not heard of the term, or defined it in a way which was incomplete. Insights are provided in to doctors and nurses experiences of palliative care, an example of which is that the personality of the healthcare provided was a significant factor in the quality of palliative care. The findings suggested that as a specialism, palliative care is seen as unique and growing, and participants understood the need and importance of this area. Issues and problems with palliative care were identified, including issues with communication and lack of material and human resources. Various opinions were offered as to the role of the media in promoting palliative care in KSA, issues with medication, including access and procedures, were discussed, and finally the participants spoke about their vision of the future of palliative care in KSA, and what would be needed to achieve this vision. The contribution of the present study to the understanding of the perceptions of healthcare workers in KSA towards palliative care is significant considering the scarcity of research in this area, particularly qualitative research. It supports the findings of previous research into palliative care in KSA and the wider research on palliative care. It also provides a unique insight into the views of healthcare workers in an Islamic culture, expanding upon current literature.