‫بسم الله الرحمن الرحيم‬

University of Bahri
Faculty of Nursing Science
Program of Master in Critical care And Emergency

Nurse's Knowledge and Practice toward Palliative

Care Of Cancer Patient

In Khartoum Oncology Center 2018

This Submitted Partial Fulfillment of M.Scs. Degree in Nursing

Science Critical care and Emergency

Prepared By:- Al-Rsheed Bakri Abdallah

Supervisor:- Dr. Hijazy

April 2018
(1.1) Background:-
Cancer is a generic term for a large group of diseases
characterized by the growth of abnormal cells beyond their
usual boundaries that can then invade adjoining parts of the
body and/or spread to other organs. Other common terms used
are malignant tumors and neoplasms. Cancer can affect almost
any part of the body and has many anatomic and molecular
subtypes that each require specific management
strategies.Cancer is the second leading cause of death globally
and accounted for 8.8 million death in 2015. Lung, prostate,
colorectal, stomach and liver cancer are the most common
types of cancer in men, while breast, colorectal, lung, cervix
and stomach cancer are the most common among women.(6)

There are more than 360,000 new cancer cases in the UK

every year, that's nearly 990 every day (2013-2015).(7)
Palliative care is an approach that improves the quality of life
of patients (adults and children) and their families who are facing
problems associated with life-threatening illness. It prevents and
relieves suffering through the early identification, correct
assessment and treatment of pain and other problems, whether
physical, psychosocial or spiritual. Each year, an estimated 40
million people are in need of palliative care, 78% of them people
live in low- and middle-income countries. Worldwide, only about
14% of people who need palliative care currently receive it.(8)

Pain is one of the most frequent and serious symptoms

experienced by patients in need of palliative care. Opioid
analgesics are essential for treating the pain associated with many
advanced progressive conditions. For example, 80% of patients
with AIDS or cancer, and 67% of patients with cardiovascular
disease or chronic obstructive pulmonary disease will experience
moderate to severe pain at the end of their lives.(8)
Nurses who work in palliative care work to improve a
patient’s ability to tolerate medical treatments and allow the
patient to have more control over their care by improving their
understanding of treatment options and matching their goals to
those options. The Palliative Care Nurse also helps support
family caregivers and provides practical support. Palliative Care
Nurses work in collaboration with other health providers, such as
physicians, social workers, and chaplains, within the context of
an interdisciplinary team. Composed of highly qualified,
specially trained professionals and volunteers, the team blends
their strengths together to anticipate and meet the needs of the
patient and family facing terminal illness and bereavement.(9)
(1.2) Problem Statement:-
Cancer is a leading cause of death worldwide, accounting for
8.8 million deaths in 2015. The burden of cancer has been on the
increase over the past few decades. In 2012 alone, 8.2 million
people worldwide were estimated to have died from cancer. More
than two thirds of these deaths occurred in low- and middle-
income countries.
Despite the growing burden of cancer worldwide, it continues
to receive low priority in Africa, across the continent and
specifically in Sudan. This is due to political unrest, limited health
resources, and other pressing public health issues such as
infectious diseases. Lack of awareness about the magnitude of the
current and future cancer burden among policy makers play a
major role as well. Although, the real scope of cancer in Sudan is
not known, the reported cases have increased from 303 in 1967–
6303 in 2010. According to Globocan estimates.
(1.3) Justification:-

The Khartoum Cancer Center is the mainly specialized center

in the state of Khartoum. There are 33,201 cancer patients from
all Sudan diagnosed at the Radiation and Isotope Centre in
Khartoum in 2016. prevalence rate per year was 5,000-7,000
among adults and 300-400 among children .This incidence show
by previous study done in 2016.

In the 2017 statistics, Khartoum oncology center receives more

than 1,000 cases per day. Due to this large number of patients,
the hospital has one palliative care unit containing ten beds only.
This is a great pressure for the staff working in the hospital.
Therefore, this study is to assess the qualifications of the
medical staff and their ability to work in there pressure .
(1.4) Objective:-
(1.4.1) General Objective:-

- To Study nurse's Knowledge and Practice toward Palliative

Care Of Cancer Patient

(1.4.2) Specific Objective:-

 To assess knowledge of nurses regarding palliative care of

cancer patient.
 To assess practice of nurses regarding palliative care of
cancer patient.
 To identify the barriers faced by nursing staff to provide
high-quality stereoscopic care

Methodology:-

(3.1) Study designs:

The researchers used the descriptive analytic method for data
collection and the study population has done in the hospital to
assess nurse's knowledge and practice toward palliative care of
cancer patient in in Khartoum oncology center (April – July)
2018

(3.2) Study Area:

Khartoum Oncology Center which located at Khartoum state
in Khartoum town Mr. Al Qasr Street near ENT hospital and
Khartoum Teaching Hospital , Khartoum Oncology Center is a
main of the country hospital for cancer patient its was
established in 1967, it provides therapeutic services to cancer
patients referred from hospitals in Khartoum State and all Sudan
states, which holds all chronic conditions, complex and critical.
Hospital have palliative care unit was Receive (10) case divide
in (1) Unit .
(3.3) Study population:
Nurses working in Palliative care unit in Khartoum oncology
center.
(3.3.1) Inclusion criteria:
All nurses working in Palliative care unit during period of
study 2018-2019.
(3.3.2)Exclusion criteria:
Nursing students, experience less than one year
(3.3.3)Variable:
Education level, experience in years, knowledge

(3.4) Sampling:
(3.4.1) Sample Size:
The study sample has been taken from Khartoum Oncology
Center, the total sample was (7) covered all nurse whom work in
Palliative care unit.

(3.5)Data collection tools:

Data was collected by using close questionnaire consist of
question with multiple choice for answers to assess knowledge
of nurse developed by researchers after literature review, the
observation was done by using cheek list consists procedure it
evaluate practices developed by researchers after literature
review.

(3.5.1)Technique:
The questionnaire technique was instructive method filled by
the study groups themselves.

(3.6)Data analysis:
The data was analyzed by Statistical package for social study
(SPSS)
Chapter
One
Introduction
 Chapter
Tow
Literature Review
Chapter
Three
Methodology
Chapter
Four
Result
Chapter
Five
Discussion
Chapter
Six
Reference
 1- https://www.nursesource.org/hospice.html
2- http://www.npcrc.org/content/15/About-Palliative-Care.aspx
3- http://aphn.org/background-to-palliative/
4- Clark D. From margins to centre: A review of the history of
palliative care in Cancer. Lancet Oncol. 2007;8:430–8. [PubMed]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140078/
5- Jubb AM. Palliative care research: Trading ethics for an evidence base. J Med
Ethics. 2002;28:342–46.[PMC free article] [PubMed]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140078/
6- http://www.who.int/cancer/en/
7- http://www.cancerresearchuk.org/health-professional/cancer-
statistics/incidence#heading-Zero
8- http://www.who.int/news-room/fact-sheets/detail/palliative-
care
9- https://www.nurseregistry.com/blog/palliative-care-nursing/