Where there is no XXXX : The challenge and hope of palliative care delivery in Tanzania.

@entity1 @entity158 @entity5 @entity1286
BACKGROUND: In Tanzania, a country of 42 million, access to oral @entity1286 is rare. AIM: To demonstrate the effectiveness of palliative care teams in reducing @entity1 ' @entity158 and  in increasing other positive life qualities in the absence of @entity1286 ; and to document the  psychological burden experienced by their clinical providers, trained in @entity1286 delivery, as  they observed their @entity1 suffering and in extreme @entity158 . SETTING: One hundred and forty-fie @entity5 @entity1 were included from 13 rural hospitals  spread across Tanzania. METHOD: A mixed method study beginning with a retrospective quantitative analysis of @entity5  @entity1 who were administered the APCA African POS tool four times. Bivariate analyses  of the scores at time one and four were compared across the domains. The qualitative arm  included an analysis of interviews with six nurses, each with more than fie years' palliative  care experience and no access to strong opioids. RESULTS: @entity1 and their family caregivers identifid statistically signifiant (p < 0.001)  improvements in all of the domains. Thematic analysis of nurse interviews described the  @entity1 and family benefis from palliative care but also their great distress when 'bad  cases' arose who would likely benefi only from oral @entity1286 . CONCLUSION: @entity1 living with chronic @entity5 who receive palliative care  experience profound physical, spiritual and emotional benefis even without oral @entity1286 .  These results demonstrate the need for continued advocacy to increase the availability of oral  @entity1286 in these settings in addition to palliative care services.
