Providing Palliative Care in Rural Nepal: Perceptions of Mid-Level Health Workers.

INTRODUCTION: Nepal is beginning to develop palliative care services across the country. Most people live in rural areas, where the Mid-Level Health Workers (MHWs) are the major service providers. Their views on providing palliative care are most important in determining how the service is organized and developed. AIM: This study aims to ascertain the perceptions of MHWs about palliative care in their local community, to inform service development. METHODS: A qualitative descriptive design, using focus group discussions, was used to collect data from a rural district of Makwanpur, 1 of the 75 districts of Nepal. Twenty-eight MHWs participated in four focus group discussions. The data were analyzed using content analysis. RESULT: Four themes emerged from the discussion: (i) suffering of patients and families inflicted by life-threatening illness, (ii) helplessness and frustration felt when caring for such patients, (iii) sociocultural issues at the end of life, and (iv) improving care for patients with palliative care needs. CONCLUSION: MHWs practicing in rural areas reported the suffering of patients inflicted with life-limiting illness and their family due to poverty, poor access, lack of resources, social discrimination, and lack of knowledge and skills of the health workers. While there are clear frustrations with the limited resources, there is a willingness to learn among the health workers and provide care in the community.

Perception of Students and Faculty on Problem Based Learning in Proficiency Certificate Level Nursing Program.

BACKGROUND: Patan Academy of Health Sciences intended to implement problem based learning in proficiency certificate level nursing program who have just completed grade 10. Presently in Nepal, the available literature on use of problem based learning as teaching learning methods is limited to undergraduate medicine who have passed 10+2 or equivalent. It was conducted to measure the perception of students and faculty on problem based learning in nursing program. METHODS: Nursing faculty who have been involved in teaching learning of nursing curriculum were trained to conduct problem based learning and write problem based learning case. Prior to run problem based learning case, students were also oriented for the problem based learning process. A 44 students and seven faculty returned the filled data collection tool. RESULTS: Both the students and tutors perceived that the problem based learning is an effective teaching learning method. They also found that the attributes of problem based learning such as self-directed learning, collaborative learning, team work and fun learning. Students were eager to have more problem based learning session in their curriculum. Faculty also perceived that problem based learning can be a better teaching learning methods and it can be implemented in proficiency certificate level nursing. CONCLUSIONS: This study shows the acceptance of problem based learning as a teaching learning methods in proficiency certificate level nursing program by both the students and faculty.