Construction of meanings during life-limiting illnesses and its impacts on palliative care: ethnographic study in an African context

David A. Agom (Lead / Corresponding author), Sarah Neill, Stuart Allen, Helen Poole, Judith Sixsmith, Tonia C. Onyeka, Jude Ominyi

Research output: Contribution to journalArticle

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Abstract

Objective: knowledge about how people make meaning in cancer, palliative and end of life care is particularly lacking in Africa, yet it can provide insights into strategies for improving palliative care (PC). This study explored ways in which cancer patients, their families and healthcare professionals construct meaning of their life-limiting illnesses and how this impact on provision and use of PC in a Nigerian hospital.

Methods: This ethnographic study utilised participant observation, informal conversations during observation and interviews to gather data from 39 participants, comprising service-users and healthcare professionals (HCPs) in a Nigerian hospital. Data was analysed using Spradley’s framework for ethnographic data analysis.

Results: Meaning-making in life-limiting illness was predominantly rooted in belief systems. Most patients and their families, including some HCPs, perceived that cancer was caused by the devil, mystical or supernatural beings. They professed that these agents manifested in the form of either spiritual attacks or that wicked people in society used either poison or acted as witches/wizards to inflict cancer on someone. These beliefs contributed to either non-acceptance of, or late presentation for, PC by most of patients and their families, whilst some professionals depended on supernatural powers for divine intervention and tacitly supporting religious practices to achieve healing/cure.

Conclusion: Findings revealed that cultural and religious worldviews about life-limiting illnesses were used in decision-making process for PC. This, therefore, provided evidence which could improve the clinicians’ cultural competence when providing PC to individuals of African descent, especially Nigerians, both in Nigerian societies and in foreign countries.
Original languageEnglish
Pages (from-to)2201-2209
Number of pages9
JournalPsycho-Oncology
Volume28
Issue number11
Early online date20 Aug 2019
DOIs
Publication statusPublished - Nov 2019

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Keywords

  • Africa
  • Nigeria
  • belief systems
  • cancer
  • culture
  • meaning-making
  • oncology
  • palliative care
  • religion

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