Global Palliative Care

P 193 EXPERIENCE OF LIVING WITH ADVANCED HEARTFAILURE IN UGANDA

Elizabeth Namukwaya,1,2 Scott Murray,1 Mhoira Leng,1,2,3 Julia Downing,2

Liz Grant1. 1University of Edinburgh, Edinburgh, United Kingdom; 2MakererePalliative care unit, Department of Medicine Makerere University; 3CairdeasInternational Palliative Care Trust

10.1136/bmjspcare-2014-000654.234

Background Health systems in Africa which were mainlydesigned to manage acute communicable diseases based on abiomedical model now need to be able to handle the emergingnon-communicable disease epidemic. Cardiovascular diseasessuch as heart failure are increasingly prevalent. Research fromhigh income countries reveals that patients with heart failurehave multidimensional needs especially a high symptom burdeneven when on drugs with a mortality benefit. We predict out-comes are likely to be even worse in African settings whereaccess to these drugs is limited and poverty is rampant.Currently palliative care is mainly for HIV and cancer patientsand has little impact on heart failure patients. In order to plancare based on needs it is necessary to elicit patients’ perspectivesof their needs and experiences of living with incurable illness.Aim To understand the multidimensional experiences, needs,and use of services of patients living and dying of heart failure.Methods In depth qualitative interviews are being conductedusing the grounded theory approach with patients with heartfailure recruited in Mulago hospital in Uganda. The interviewsare supplemented by administering the African APCA POS ques-tionnaire. Purposive sampling is being used for recruitment.Thematic saturation is expected to be achieved at a total of about16 patients.Results Preliminary analysis has identified the following themes:Lack of awareness of symptoms of heart failure which lead to latepresentation, association of symptoms to witchcraft, significantdistress from physical symptoms, recurrent admissions, increasingdependency associated with loss of dignity, loss of valued self,psychological distress, different theological ideas relating illnessand the Divine and financial problems.Conclusion Heart failure patients in Uganda have multidimen-sional needs some of which are similar to high income countriesbut others are unique to the African setting. Such patients couldgreatly benefit from a palliative approach.

A82 BMJ Supportive & Palliative Care 2014;4(Suppl 1):A1–A110

Abstracts

group.bmj.com on March 23, 2014 - Published by spcare.bmj.comDownloaded from

doi: 10.1136/bmjspcare-2014-000654.234 2014 4: A82BMJ Support Palliat Care

 Elizabeth Namukwaya, Scott Murray, Mhoira Leng, et al. HEART FAILURE IN UGANDAEXPERIENCE OF LIVING WITH ADVANCED

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