Developing a prioritized Kenyan palliative care research agenda: a consensus study using a modified Delphi method with longitudinal surveys among palliative healthcare professionals

Abstract

Despite growing demand for palliative care in Kenya, there remains limited evidence grounded in the needs and priorities of healthcare providers to guide palliative care service delivery. A modified Delphi method was used with providers working at Kenyan palliative / hospice care organizations in two-phased longitudinal survey phases: in Phase 1 respondents were asked to identify up to five palliative care research priorities that they thought were extremely important but not addressed. The resulting thematic areas. were analysed, with the top ten generated. In Phase 2, participants were provided these ten questions and asked to rank the importance of their top five on a scale of 1 to 5, with “1” being the most important. Phase 1 and 2 surveys were completed by 93 and 99 participants, respectively. Among respondents who completed the Phase 2 survey, 79.3% (69 of 87) were females, 93.9% (62 of 66) had a college degree or higher, 54.1% (46 of 80) were nurses and 9.4% (8 of 80) were physicians, with an overall mean age of 44.3 years (SD = 9.17). The top ten ranked research priorities included: (1) Palliative care integration in the health system; (2) Barriers to palliative care delivery; (3) Governmental support for palliative care delivery; (4) The role of community health workers in delivering palliative care; (5) Challenges to communication with patients and families; (6) Improving patient access to palliative care; (7) Improving palliative care training for healthcare providers; (8) Improving support for clinical and non-clinical caregivers; (9) Identifying the most effective palliative care delivery programs, and; (10) Healthcare providers’ palliative care knowledge, attitudes and practices. This study identifies key evidence gaps in palliative care where research is needed to inform palliative care service delivery in Kenya. It provides evidence for policymakers, advocates, funding agencies and researchers to help inform the development of targeted research and funding to improve care outcomes for Kenyan patients and family members affected by life-limiting illnesses.