Interdisciplinary Team Strategies for Terminally Ill Clients and Families Experiencing anticipatory grief In Home-Based Care In Kenyan low-Income communities: A Systematic Review

The study evaluated the effectiveness of interdisciplinary team strategies for helping terminally clients and families experiencing anticipatory grief in home-based care. Interdisciplinary teams represent the collaborative working between professionals from various disciplines including physicians, psychiatrists, psychologists, nurses, social workers, and other trained volunteers as well as spiritual leaders with the aim of addressing various needs of patients or clients with terminal illnesses and their families. Most patients diagnosed with life-limiting illnesses such as cancer, Alzheimer’s disease among other life threatening illnesses may have multiple and complex needs. Facing end of life due to advanced severe illness can result in psychological pain and distress associated with anticipatory grief. Such clients and their families require integration of interdisciplinary team strategies to their care regimen so as to help them cope with psychosocial issues and complex multi-morbidity. Sustained levels of anticipatory grief can result in serious health risks including serious mental health disorders like clinical depression in patients faced with end-of-life and members of their families. Although little evidence exists regarding the risk factors of anticipatory grief, some empirical evidence point to a serious state of emotional suffering that may require integration of support from an interdisciplinary approach. However, the approaches aimed at addressing the end-of-life psychosocial issues in Africa and Kenya in particular may not be similar with those utilized in the western world and many of them are not well documented. There was need to assess the effectiveness of strategies being implemented by interdisciplinary teams to address issues related to anticipatory grief in terminally ill clients and families in home-based programmes in Kenyan communities. To establish the effectiveness of the strategies used, a systematic literature review was conducted through identification of relevant published articles in various databases including Clinical trials, MEDLINE, PubMed, and PsycINFO, in addition to a hand search on relevant journals, dating from 2000 to 2020. To ensure quality of the findings, only articles and studies published in reputable journals and databases were included in the synthesis. The selection criteria focused on studies using qualitative methods or mixed methods so as to ensure consistency of study designs. The search identified 15 articles, which were assessed to establish quality for inclusion, after which 7 that met the criteria were included in the synthesis. All the included articles represented a population of 290 respondents drawn from various regions in Kenya, and focused on various themes, including communication, dignity therapy, spiritual care, and psychosocial support. The results from the reviewed articles indicated that communication, dignity therapy and general structured counselling as well as spiritual support were helpful in end-of-life care, thus establishing a level of effectiveness in addressing anticipatory grief in clients with terminal illnesses and their families. The study recommended that extensive training on grief counselling methods was required on communication proficiency of care providers. More research was recommended on effectiveness of other interventions that were not evaluated in this review.