PERSPECTIVES OF HEALTHCARE PROVIDERS ON ADVANCE DIRECTIVES IN THE CRITICAL CARE UNIT AT NAIROBI HOSPITAL, NAIROBI CITY COUNTY, KENYA
PERSPECTIVES OF HEALTHCARE PROVIDERS ON ADVANCE DIRECTIVES IN THE CRITICAL CARE UNIT AT NAIROBI HOSPITAL, NAIROBI CITY COUNTY, KENYA
Juma Ndubi Levy (Kenya Registered Nurse (KRN), B.Sc. N) - Department of Medical-Surgical Nursing and Pre-Clinical Sciences, Kenyatta University, Kenya
Dr. Sarah Tai Bett (PhD, RN) - Department of Medical-Surgical Nursing and Pre-Clinical Sciences, Kenyatta University, Kenya
Lucy Wankuru Meng’anyi (RN) - Department of Medical-Surgical Nursing and Pre-Clinical Sciences, Kenyatta University, Kenya
ABSTRACT
Background: Advance directives involve a process of discussion and reflection on personal values, wishes, and preferences about future healthcare decisions. Notably, decision-making during end-of-life healthcare is emotional and stressful since it is a focal point for conflict within the patient and between families and healthcare providers. In Africa, advance directives are hardly mentioned and if discussed, its mainly within the hospital set up. This is an unexplored area since there are inadequate African studies with a limited understanding of advance directives including cultural beliefs and practices challenging the utilization of advance directives among the African people. Objective: The study described healthcare providers' perspectives on advance directives at Nairobi Hospital critical care unit. Methodology: A descriptive qualitative approach was used where 18 healthcare providers were interviewed, including critical care nurses, consultants, and critical care unit resident doctors, using in-depth interviews. Purposive sampling was used to select the healthcare providers long side snowballing targeting most experienced participants. Interviews were audio-recorded, transcribed and analyzed using thematic analysis through the NVivo15. Results described the understanding, treatment choices, and healthcare provider’s experiences with advance directives. It also highlighted the importance of awareness creation through educational programs and legal-policy guidelines in promoting advance directives. Conclusion: Addressing challenges to include primary care physician gap, family conflict and inadequate legal-policy guidelines requires a collaborative effort in creating an environment where advance directives are accepted and effectively implemented.
