Palliative care need among inpatients in acute general hospitals in Nepal: a point prevalence survey

Introductions:  Developing palliative care services in acute hospitals is important to address the need of patients dying from malignant and non-malignant diseases. This study is carried out to assess the need of palliative care in Patan Hospital to inform the planning process for starting palliative care services.Methods: A cross-sectional, point prevalence survey of in-patient beds occupied in Patan Hospital was carried out using Supportive and Palliative Care Indicators Tool. For patients who met the criteria, symptom burden was noted.Results: Of the 116 patients admitted on the day of surveillance, 30% met the criteria for palliative care need; 60% were aged 60 or above. The most common conditions requiring palliative care need was lung disease (46%) followed by cardio vascular (23%) and neurological diseases (23%). The most common symptoms patients were suffering from were fatigue (60%) followed by shortness of breath (51%), inability to move (35%), abdominal distension (31%), anorexia (31%) and pain (25%).Conclusions: Almost one third of patients admitted to Patan Hospital need palliative care with majority of them being above sixty years. This highlights the need to develop palliative care services in the hospital to address the need of such patients and families to improve the quality of life in the last years of life.Keywords: acute hospital, need assessment, palliative care, SPICT too

Determinants of Postgraduate Students' Choices of Speciality

Introduction: Postgraduate specialization is perceived as essential for success with high competition for enrolment. The reasons how medical students choose their postgraduate specialty are complex. Understanding the factors that influence career choice helps in workforce planning. So, we tried to identify the specialty preferred by postgraduate students and the factors that influenced these choices in a post graduate institution. Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences. All the postgraduate students of batch 2011 AD were enrolled for the study. The responses were rated on a five point Likert scale. Results: Significant gender preference was observed in specialties. General Surgery, Internal Medicine and Orthopedics were chosen by male students (P-Values, respectively, 0.001, 0.033 and 0.000) while Obstetrics and Gynecology and Ophthalmology being chosen by female students (P-Values, respectively, 0.000 and 0.006). Significant difference was observed between male and female student responses to the factor – scope in future (P – value 0.042), between married and unmarried students to the factor – workload flexibility (P – value 0.011), students who tried to go abroad versus who didn’t, for the factor – Illness of self/family/friend (P – value 0.016), and between those who worked in rural area versus those who didn’t, to the factor – Influence of friends/ seniors (P – value 0.038). Conclusions: Various factors affect the choices for preferred specialty. Policy makers should look at the needs of the nation, and ensure that specialty postgraduate education programs reflect those needs.  Keywords: career choices; likert scale; medical education; postgraduate specialty. | PubMe

Determinants of Postgraduate Students' Choices of Speciality

Introduction: Postgraduate specialization is perceived as essential for success with high competition for enrolment. The reasons how medical students choose their postgraduate specialty are complex. Understanding the factors that influence career choice helps in workforce planning. So, we tried to identify the specialty preferred by postgraduate students and the factors that influenced these choices in a post graduate institution. Methods: A cross-sectional observational study was conducted in National Academy of Medical Sciences. All the postgraduate students of batch 2011 AD were enrolled for the study. The responses were rated on a five point Likert scale. Results: Significant gender preference was observed in specialties. General Surgery, Internal Medicine and Orthopedics were chosen by male students (P-Values, respectively, 0.001, 0.033 and 0.000) while Obstetrics and Gynecology and Ophthalmology being chosen by female students (P-Values, respectively, 0.000 and 0.006). Significant difference was observed between male and female student responses to the factor – scope in future (P – value 0.042), between married and unmarried students to the factor – workload flexibility (P – value 0.011), students who tried to go abroad versus who didn’t, for the factor – Illness of self/family/friend (P – value 0.016), and between those who worked in rural area versus those who didn’t, to the factor – Influence of friends/ seniors (P – value 0.038). Conclusions: Various factors affect the choices for preferred specialty. Policy makers should look at the needs of the nation, and ensure that specialty postgraduate education programs reflect those needs. Keywords: career choices; likert scale; medical education; postgraduate specialty. | PubMe