Palliative Care

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1.1 Introduction
Palliative care in South Africa was recognised towards the end of the 1970s primarily in Johannesburg, Cape Town, Durban and Port Elizabeth (Sithole, 2012:7). In 1979, Dame Cecily Saunders (founder of palliative care in the United Kingdom) aided the formation of hospice programmes in South Africa and the initial hospice programmes were based on the United Kingdom model (Sithole, 2012:7). Fourteen hospices in South Africa came together to form a national association called the Hospice Association of South Africa (HASA) in the course of 1988 (Sithole, 2012:7). Prior to 1988, hospices dealt primarily with oncology (cancer) patients, however, with the high impact of the HIV/AIDS illness in South Africa, hospice programmes changed
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Palliative care was established on the principles of merging teaching and clinical research, expert pain and symptom relief with holistic care to meet the physical, social, psychological and spiritual needs of its patients and those of their family and friends (Sithole, 2012:10).
According to Green and Horne (2009) the following are principles of palliative care:
• Quality of life: Service provide should not define the quality of life but it should be defined by the individual.
• Respect and participatory: Patients and families have the right to make choices, use their cultural, customs and personal values, confidentiality, and be treated with dignity.
• Holistic: To address diverse needs of patients and the family, interdisciplinary teams should be involved to attend to the emotional, spiritual and social aspects of
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They play an important role in several aspects of pain care, which include providing an empathetic and therapeutic presence to patients and families, which includes support for bereavement, throughout the dying process, advocating for and supporting persons in their experience of living and dying, honoring the values and health-care wishes of persons and supporting families; developing a patient-centered treatment plan, providing support and intensive caring; fostering hope; providing comfort; providing empathic relationship; enhancing personal growth; responding to colleagues; enhancing quality of life during dying and responding to the family (Lugton & McIntyre, 2005:17-18).

The components of the nurses’ role in palliative care is valuing the patients, meaning that nurses must have respect for the inherent worth of others (Walshe & Luker, 2010:1168). Many nurses have personal commitments to patients and a genuine desire to do good which influences their approach to care (Walshe & Luker, 2010:1177). Secondly, the nurses’ role is providing emotional support. Emotional support is believed to be the most important as perception of support is conveyed to others (Skilbeck & Payne,

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