Palliative and EOL care in Trinidad and Tobago
Abstract project
Introduction
This is the first time a broad study on palliative and end-of-life care is being undertaken in Trinidad and Tobago. The project proposes to develop a population level intervention model that may be generalizable to other small Island developing countries with underdeveloped palliative and end-of-life care policies and infrastructure. There are three phases, phase 1 considers what is being discussed in the literature; phase 2 seeks to understand the circumstances of how and where people are dying; phase 3 intends to evaluate end-of-life care needs and barriers for optimal end-of-life care at formal and informal levels
Background
English-speaking Caribbean nations are Small Island developing states. They share common cultural and socio-economic backgrounds as well as common challenges in providing palliative and end-of-life Care to their citizens. Relatively little is known about the circumstances of dying and palliative and end-of-life care needs in the Caribbean.
For Trinidad and Tobago, one of the Caribbean countries focused on in this project, there is an urgent need for scientific data to address the circumstances and aspects of quality of care at the end of life.
Aim
The project has three objectives:
1) to identify common themes documented in diverse literature on palliative and end-of-life care focusing only on English-speaking Caribbean, and to describe barriers and improvement strategies being formulated in the literature and to suggest ways forward
2) To examine patterns of place of death in Trinidad and Tobago:
- to examine what factors influence place of death in all deaths occurring in 2011 in Trinidad and Tobago eligible for palliative care, and to determine how well mortality death certificates describe the place of death; and
- to examine trends in where people have died in Trinidad and Tobago from 1985 to 2010
3) To examine the circumstances of dying and the prevalence and characteristics of medical end-of-life decisions in Trinidad.
Method
There are three studies:
Study 1: A systematic scoping study of publications identified through Medline and Web of Science databases, hand searches and grey literature was conducted to map key concepts and summarize themes.
Study 2: A study using mortality data negotiated from the national statistics office including place of death and possibly associated variables
Study 3: A retrospective cross-sectional study based on a random sampling of incoming death certificates at the Central Statics Office; questionnaires sent to physicians will ask them to report on end-of-life decisions they made in attending deaths in a regional health authority in Trinidad.
