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New integrated African Palliative Care Outcomes Scale to be developed in Zimbabwe

Author: Franciscah Tsikai, Val Maasdorp and Bev Sebastian
12 April 2017

The staff at Island Hospice and Healthcare (Island) in Harare, Zimbabwe, were delighted to welcome Dr Richard Harding this March on his first visit to Africa’s first hospice.

Dr Harding is Reader in Palliative Care at the Cicely Saunders Institute at Kings College London. He has contributed significantly to hospice and palliative care research throughout Africa, and collaborated with the African Palliative Care Association to develop the African Palliative Care Outcomes Scale (APCA-POS).

The purpose of this visit was to train Zimbabwean palliative care practitioners on the use of the palliative care outcome scale (POS).

The POS measures are a family of tools to measure patients' physical symptoms, psychological, emotional, spiritual, and information and support needs. They are validated instruments that can be used in clinical care, audit, research and training.

Training participants were drawn from Harare, Mutare and Marondera, Bulawayo and Seke Rural. They ranged from a doctor, nurses, social workers, an associated NGO worker working with vulnerable children, M&E staff, and the Island CEO.

During the two days together, several topics were discussed and participants gained a greater understanding of how the POS can be used to help improve the quality of life of patients and as a resource for research. 

For example, they discussed research which shows that, in general, families over estimate a patient’s pain and clinicians under estimate that same patient’s pain.

The group discussed the possibility of investigating this within the context of Zimbabwe, using data collected from the POS over time.

The opportunity to merge the APCA POS with the Integrated POS was very exciting.

During discussions about the organisation’s implementation of the tool, it was agreed that Island would validate the integration of the IPOS and the APCA POS into the New Integrated African POS together with Dr Harding.

Following training, Island staff devised plans for the piloting, evaluation and roll out of the ‘New Integrated African POS’ at Island.

In addition to training, Dr Harding joined the team on a home visit where he met a patient Island is supporting within the community.  

In accordance with a multi disciplinary approach, the visit was conducted by nurse Chenjerai Bhodheni and social worker Monalisa Matonda.

Mr Bhodheni said: “From the time I heard (Dr Harding) was heading to Zimbabwe, it was like a dream coming true for me. I and my colleague Monalisa were lucky to have a few moments well spent with Dr Harding.

“The time was indeed very short but we experienced a patient home visit together. A big thank you to Dr Richard Harding for being so empathetic and getting to the level of our needy patients. We learnt some very important lessons from you.”

Dr Harding said: “It was a pleasure to visit Africa’s first hospice, and to see the work of Dame Cicely (Saunders) continuing in the world. I was impressed by Island’s commitment to quality and their focus on measuring the outcomes of the care that they deliver.

“I am delighted that Island will be joining the many, many others across Africa who routinely implement the APCA African POS in their daily practise to better understand patient and family priorities, and to monitor change.

“Their adoption of a new version with expanded symptom items will be an important development in the mission to expand access to  quality palliative care in Africa.”

Evaluations from participants overwhelmingly found that there was agreement that the IPOS tool will improve our palliative care work.

Island’s new Monitoring, Evaluation and Research Officer, Goodshow Bote noted: “The use of the IPOS will be used to improve the quality of life of patients because we will be tracking patient outcomes in the areas that count.”

You can find more information about the IPOS online.

Find out more about Island Hospice and Healthcare on their website, follow IslandHospiceZW on Twitter, Instagram and Facebook, and donate to support their important work via Global Giving: https://www.globalgiving.org/projects/island-hospice-and-healthcare/

Island Hospice and Healthcare will shortly be launching a new website, make sure you visit the site to keep up to date with their work.

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