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Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

Author

Listed:
  • Tamara Rodríguez Quintana

    (Department of Health Sciences, Universidad Técnica Particular de Loja (UTPL), Loja 110107, Ecuador)

  • Viviana Dávalos-Batallas

    (Department of Health Sciences, Universidad Técnica Particular de Loja (UTPL), Loja 110107, Ecuador)

  • Ana-Magdalena Vargas-Martínez

    (Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain)

  • Lucelly López

    (Research Department, School of Medicine, Universidad Pontificia Bolivariana, Calle 78B # 72A-109, Medellín 050001, Colombia)

  • Patricia Bonilla-Sierra

    (Department of Health Sciences, Universidad Técnica Particular de Loja (UTPL), Loja 110107, Ecuador)

  • María-de-las-Mercedes Lomas-Campos

    (Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain)

  • Fatima Leon-Larios

    (Nursing Department, School of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain)

Abstract

Ecuador assumed the commitment of including Palliative Care (PC) in its health policies. In 2014, the Ministry of Public Health (Ministerio de Salud Pública, MSP) approved the Clinical Practice Guide for Palliative Care ( Guía de Práctica Clínica sobre Cuidados Paliativos , GPCCP), with application at the national level, as a mandatory internal regulation in all institutions belonging to the National Health System. In 2021, there is no evidence about the degree of implementation. The objective was to evaluate the implementation (I) of the GPCCP guide and the knowledge (C) of the health personnel working in the Zone 7 Health Centers (HCs). This is a cross-sectional, descriptive, and prospective study. A total of 292 professionals were interviewed: managers (38), physicians (150), and nurses (104). Three surveys based on the GPCCP guide were elaborated: one for the implementation, which was applied to the individuals in charge, and the others to assess the health professionals’ knowledge. The SPSS program was used, version 25. In the three groups, more than half of the participants had no training in PC, 91.2% of the HCs have the GPCCP guide, there is PC medical history (MH) in 38.2%, and morphine is used in 14.7%. The implementation of the GPCCP guide was inadequate in 52.9% of the cases. Only 25% treat the agony symptoms and 30%, delirium; 4.4% acknowledge the use of morphine in dyspnea, and 13.3% identify the subcutaneous route as the first choice for hydration at the end-of-life phase. Strategies to implement the GPCCP guide and to improve the health personnel’s knowledge must be implemented in Zone 7 centers.

Suggested Citation

  • Tamara Rodríguez Quintana & Viviana Dávalos-Batallas & Ana-Magdalena Vargas-Martínez & Lucelly López & Patricia Bonilla-Sierra & María-de-las-Mercedes Lomas-Campos & Fatima Leon-Larios, 2021. "Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level," IJERPH, MDPI, vol. 18(21), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:21:p:11573-:d:671797
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    References listed on IDEAS

    as
    1. Paula Hidalgo-Andrade & Guido Mascialino & Diego Miño & Matías Mendoza & Anna Belén Marcillo, 2021. "Knowledge of Palliative Care in Ecuador," IJERPH, MDPI, vol. 18(9), pages 1-8, April.
    2. May, Peter & Hynes, Geralyn & McCallion, Philip & Payne, Sheila & Larkin, Philip & McCarron, Mary, 2014. "Policy analysis: Palliative care in Ireland," Health Policy, Elsevier, vol. 115(1), pages 68-74.
    3. Viviana Dávalos-Batallas & Vinita Mahtani-Chugani & Carla López-Núñez & Víctor Duque & Fatima Leon-Larios & Maria-de-las-Mercedes Lomas-Campos & Emilio Sanz, 2020. "Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study," IJERPH, MDPI, vol. 17(11), pages 1-14, May.
    4. Carlos Seiça Cardoso & Filipe Prazeres & Beatriz Xavier & Bárbara Gomes, 2021. "Family Physicians’ Perspectives on Their Role in Palliative Care: A Double Focus Group in Portugal," IJERPH, MDPI, vol. 18(14), pages 1-12, July.
    5. Patricia Bonilla-Sierra & Ana-Magdalena Vargas-Martínez & Viviana Davalos-Batallas & Fatima Leon-Larios & Maria-de-las-Mercedes Lomas-Campos, 2020. "Chronic Diseases and Associated Factors among Older Adults in Loja, Ecuador," IJERPH, MDPI, vol. 17(11), pages 1-15, June.
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