Community engagement and -education are proposed to foster equity in access to care and to ensure dignity of migrant patients in the last phase of life, but evidence is lacking. We evaluated nine community educational interactive meetings about palliative care (136 participants totally)- co-created with educators from our target groups of Moroccan, Surinamese and Turkish migrants-with a mixed methods approach, including 114 questionnaires, nine observations, nine interviews with educators, and 18 pre- and post- group- and individual interviews with participants. Descriptive and thematic analysis was used. 88% of the participants experienced the meetings as good or excellent. Educators bridged an initial resistance toward talking about this sensitive topic with vivid real-life situations. The added value of the educational meetings were: (1) increased knowledge and awareness about palliative care and its services (2) increased comprehensiveness of participant's wishes and needs regarding dignity in the last phase; (3) sharing experiences for relief and becoming aware of real-life situations. Community engagement and -education about palliative care for migrants effectively increases knowledge about palliative care and is a first step towards improved access to palliative care services, capacity building and a dignified last phase of life among migrants.
This research paper revolves around the process of the quantification of bupivacaine in human plasma through the selection of a sensitive high performance liquid chromatography method. The extraction of bupivacaine and ropivacaïne as an internal standard from plasma was performed through the use of hexane along with iso-propylalcohol. After liquid-liquid extraction we moved straightforward to the process of the mobile phase in which we had a combination of acetonitrile and potassium dihydrogen phosphate (65:35, v/v). The separation was carried out on a reversed phase C18 column with UV-detector at 210 nm for bupivacaine and 230nm for the internal standard. This particular examination exhibited excellent linearity (r2=0.999) in peak response over the concentration range of 0.1–1.5µg/mL bupivacaine in human plasma. The mean absolute recoveries for 0.5 and 1.5µg/mL of bupivacaine in plasma using the present extraction procedure were 97.43% and 95.03%, respectively. The intra- and inter-day coefficients of variation in the plasma were less than 12% at the lowest, and less than 10% at other concentrations, and the percent error values were less than 6%. The method displayed a high caliber of sensitivity and selectivity for therapeutic monitoring concentrations of bupivacaine in human plasma.
BACKGROUND: Preserving personal dignity is an important part of palliative care. Generally, autonomy, independency and not being a burden to others are emphasised for preserving dignity. Dignity has not been studied yet from the perspective of the growing group of patients with a migration background living in Western countries.
AIM: To gain insight into (1) what patients - and their relatives - with a Turkish, Moroccan or Surinamese background, living in the Netherlands, in their last phase of life find important aspects of dignity, and (2) how care professionals can preserve and strengthen the dignity of these patients.
DESIGN: Qualitative thematic analysis of semi-structured interviews.
PARTICIPANTS: A total of 23 patients and 21 relatives with a Turkish, Moroccan or Surinamese background were interviewed.
RESULTS: For respondents dignity encompassed surrender to God's or Allah's will and meaningful relationships with others, rather than preserving autonomy. Surrender to God or Allah meant accepting the illness, the situation and performing religious practice. A meaningful relationship meant being assisted or cared for by family members and maintaining a social role. Professionals could preserve dignity by showing respect and attention; guaranteeing physical integrity, hygiene and self-direction; and indirect communication about diagnoses and prognoses.
CONCLUSIONS: Religion and appropriate involvement of family members are important aspects of dignity in the last phase of life, in addition to autonomy and independency. Care professionals need to take these factors into account in order to provide person-centred care.
This study aims to elicit the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward dying, death, and the afterlife; to identify whether differences are observable between middle-aged and elderly participants and to document how the actual attitudes of our participants relate to normative Islamic literature. Interviews were conducted with middle-aged and elderly Moroccan women living in Belgium (n = 30) and with experts in the field (n = 15). This study reveals that the belief in an omnipotent and omniscient God and in an afterlife strongly marks the attitudes of first- and second-generation Muslims in Belgium toward life and death.
Objective: The aim of this study is to assess the quality of life of caregiver's. The study was conducted at the RABAT National Institute of Oncology in MOROCCO.
Results: 120 patients on the palliative phase of advanced cancer were included. Severe fatigue was observed in 64.2% of patients with an average of 90.55±14.7. There was a positive association between functional dimensions and overall quality of life and a negative association between symptoms and overall quality of life. Patients under 30 years had a lower quality of life. According to the multi-varied analysis, physical function, emotional functioning and fatigue were significant predictors of Health related quality of life/overall quality of life (p<0.05).
This study aimed to elicit the attitudes and beliefs of middle-aged and elderly Moroccan Muslim women regarding mourning and remembrance, to identify whether differences are observable between middle-aged and elderly participants, to explore the role of religion and to document how the actual attitudes of our participants relate to normative Islamic literature. Interviews were conducted with middle-aged and elderly Moroccan women living in Belgium (n = 30) and with experts in the field (n = 15). This study reveals that the religious beliefs have a great impact on the views of Muslim women. We found striking similarities between our participants’ views and normative Islamic literature.
Visant l'amélioration de la qualité de vie des patients et de leurs proches face aux conséquences de maladies cancéreuses, le Ministère de la santé en partenariat avec la Fondation Lalla Salma et l'Institut National d'oncologie à Rabat ont procédé, en mai 2012, à la mise en place de l'expérience pilote de soins palliatifs au niveau de la préfecture de Rabat. L'objectif principal de notre investigation est d'analyser le degré de mise en oeuvre de ce projet, ainsi d'identifier les facteurs contextuels influençant cette mise en oeuvre. Menée entre novembre 2016 et mars 2017 et basée sur une méthode descriptive et qualitative, notre étude consiste à une analyse d'implantation du projet pilote des soins palliatifs à la préfecture de Rabat. Nos résultats sont à l'origine des données collectées à l'aide de trois stratégies distinctes : l'analyse documentaire, des entrevues qualitatives semi-dirigées, et des observations non participatives. La méthode d'appariement est la stratégie choisie pour l'analyse des données. Sur la base des informations disponibles, il a été défini pour le degré de mise en oeuvre du projet de soins palliatifs, des points forts et des points à améliorer. De même, il découle de l'analyse des résultats que l'implantation du projet a été marquée et conditionnée par des facteurs favorables et d'autres non favorables à son implantation. Afin d'assurer un accès équitable aux soins palliatifs au Maroc et de garantir la viabilité et la pérennité au projet de SP, des pistes d'amélioration devront être apportées ; à l'intégration des soins palliatifs dans les SSP et dans les hôpitaux ; à l'actualisation de la réglementation qui régit l'activité des soins palliatifs et les produits médicamenteux ; à l'élaboration de programme de sensibilisation et de formation continue pour les professionnels de santé et à l'amélioration de la qualité du circuit de l'information et des canaux de communication entre les niveaux. (R.A.).
Origine : BDSP. Notice produite par ENSP-MAROC FH88R0xn. Diffusion soumise à autorisation
The technological advances in medicine, including prolongation of life, have constituted several dilemmas at the end of life. In the context of the Belgian debates on end-of-life care, the views of Muslim women remain understudied. The aim of this article is fourfold. First, we seek to describe the beliefs and attitudes of middle-aged and elderly Moroccan Muslim women toward withholding and withdrawing life-sustaining treatments. Second, we aim to identify whether differences are observable among middle-aged and elderly women's attitudes toward withholding and withdrawing life-sustaining treatments. Third, we aim to explore the role of religion in their attitudes. Fourth, we seek to document how our results are related to normative Islamic literature. Qualitative empirical research was conducted with a sample of middle-aged and elderly Moroccan Muslim women (n = 30) living in Antwerp (Belgium) and with experts in the field (n = 15). We found an unconditional belief in God’s sovereign power over the domain of life and death (cf. determined lifespan by God) and in God’s almightiness (cf. belief in a miracle). However, we also found a tolerant attitude, mainly among our middle-aged participants, toward withholding and withdrawing (treatment) based on theological, eschatological, financial and quality of life arguments. Our study reveals that religious beliefs and worldviews have a great impact on the ethical attitudes toward end-of-life issues. We found divergent positions toward withholding and withdrawing life-sustaining treatments, reflecting the lines of reasoning found in normative Islamic literature. In our interviews, theological and eschatological notions emerged as well as financial and quality of life arguments.
Cet article se propose d'analyser la situation des personnes âgées veuves ou veufs. Leur poids démographique, leurs conditions socio-économiques, la solidarité familiale et leur dépendance à leur entourage ainsi que les inégalités de genre sont les principaux éléments discutés dans cet article.
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