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Effect of Palliative Care Education on Knowledge of Home-Based Palliative Care among Family Caregivers in Nigeria

Abstract

Palliative care is an important component of comprehensive healthcare for individuals living with serious and life-limiting illnesses and may help improve comfort, symptom management, quality of life, and support for patients and their families. In Nigeria, many patients with advanced illnesses may receive substantial care within their homes, placing family members in important caregiving roles. Family caregivers may, however, have limited knowledge of pain and symptom management, medication support, nutrition and hydration, hygiene, emotional support, communication, and appropriate use of healthcare services. Palliative care education provides an opportunity to improve caregivers' understanding of home-based palliative care and strengthen their ability to support patients safely and appropriately. Against this background, this study investigates the effect of palliative care education on knowledge of home-based palliative care among family caregivers in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Family Systems Theory. The Health Belief Model explains how caregivers' perceptions of the seriousness of patients' conditions, perceived benefits of palliative care, perceived barriers, self-efficacy, and cues to action may influence their understanding and use of home-based palliative care. Social Cognitive Theory emphasizes observational learning, self-efficacy, behavioural modelling, reinforcement, and social support in shaping caregivers' knowledge and caregiving behaviours. Family Systems Theory views the family as an interconnected unit in which changes in one member's health and caregiving responsibilities may influence other members and the overall functioning of the family. Collectively, these theoretical perspectives provide a suitable framework for explaining how palliative care education may influence knowledge of home-based palliative care among family caregivers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adult family caregivers aged 18 years and above who provide regular care to relatives living with serious or life-limiting illnesses in selected communities and healthcare facilities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, hospitals, palliative-care programmes, and eligible family caregivers. Palliative care education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on the principles and goals of palliative care, pain and symptom management, medication safety, nutrition and hydration, personal hygiene, positioning and comfort care, emotional and psychosocial support, communication with patients, recognition of worsening symptoms, appropriate healthcare-seeking, referral and follow-up, caregiver self-care, and available palliative-care services. Knowledge of home-based palliative care will be assessed using indicators such as understanding of the purpose of palliative care, recognition of common symptoms requiring attention, appropriate basic comfort measures, safe medication practices, recognition of situations requiring professional assistance, understanding of nutrition and hydration support, infection-prevention practices, communication and emotional-support principles, knowledge of available healthcare and palliative-care services, and recognition of caregiver responsibilities and limitations. Data will be collected using structured questionnaires, standardized palliative-care knowledge assessment tools, scenario-based questions, caregiver education records, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize caregivers' demographic and socioeconomic characteristics, caregiving responsibilities, patients' general care needs, previous exposure to palliative-care information, sources of health information, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of palliative care education on knowledge of home-based palliative care. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that palliative care education has a significant positive effect on knowledge of home-based palliative care among family caregivers in Nigeria. Caregivers exposed to structured, practical, culturally appropriate, and sustained palliative-care education are expected to demonstrate greater knowledge of appropriate home-based care than caregivers without comparable exposure. Education may improve caregivers' understanding of comfort-focused care, pain and symptom management, medication safety, hygiene, nutrition and hydration, emotional support, communication, and appropriate healthcare-seeking. Scenario-based demonstrations may strengthen caregivers' ability to recognize changes in patients' conditions and determine when professional medical assistance is required. Education may also improve awareness of caregiver self-care and the importance of seeking support when caregiving responsibilities become difficult to manage. However, limited access to palliative-care professionals, financial constraints, inadequate home-care resources, misconceptions about palliative care, cultural beliefs, caregiver burden, and weak referral and follow-up systems may reduce the effectiveness of education alone. The study therefore expects accessible, practical, culturally sensitive, and sustained palliative-care education, supported by functional referral systems and community-based palliative-care services, to contribute significantly to improved knowledge of home-based palliative care among family caregivers in Nigeria. The study is expected to contribute to the literature on palliative care education, home-based palliative care, family caregiving, serious illness care, symptom management, caregiver health, health education, community-based healthcare, supportive care, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, hospitals, palliative-care programmes, healthcare professionals, nurses, physicians, community health workers, social workers, caregiver-support organizations, development partners, and policymakers regarding strategies for strengthening home-based palliative care. The study will also provide evidence-based recommendations for expanding palliative-care education for family caregivers, strengthening community-based palliative-care services, improving caregiver access to reliable information and professional support, strengthening referral and follow-up systems, and developing sustainable home-based interventions that improve caregivers' knowledge and support the quality of care provided to patients with serious and life-limiting illnesses across Nigeria.

Keywords: Palliative care education, home-based palliative care, family caregivers, palliative care knowledge, serious illness, symptom management, caregiver support, home healthcare, health education, supportive care, Nigeria, public health.