Briefly, could you explain your background and career before coming to King's?
Prior to coming to King’s, I worked as a nurse at Surgical-Medical Emergency Unit of the Korle-bu Teaching Hospital in Ghana, where I had the opportunity to care for patients with various diagnosis including HIV/AIDS. I was particularly drawn to people diagnosed with HIV/AIDS as most of them often deteriorate rapidly on discovering that they were HIV positive. I wanted to investigate how best to care and support people living with HIV/AIDS (PLWHA) in order to improve their wellbeing, health outcomes and quality of life.
When I went on to do a master’s degree in nursing at Queen Margaret University, Edinburgh, I learned more about research methods, how to develop a research question and proposal in my research methods module. This led me to develop a research proposal to explore the potential of integrating palliative care into HIV/AIDS care in Ghana for my master’s dissertation, where my reading and understanding was shaped about the complex physical, psychological, social and spiritual experiences of PLWHA following diagnosis and their poorer health related quality of life (QoL) than the general population. Having also read about palliative care, which addresses broader psychosocial and spiritual concerns of patients using a person-centred approach, this then deepened my passion to adopt palliative care principles to care for PLWHA in Ghana.
However, due to the short duration of my master’s degree programme, I could not implement my dissertation proposal so, I had to find another opportunity where my proposal could come to fruition. This led me to do a PhD at King’s.
What was your experience of winning the Ghana Education trust PhD fellowship?
Winning the Ghana Education Trust Fund (GETFund) PhD fellowship was an incredibly gratifying experience. The application process was rigorous, involving the submission of a detailed research proposal, academic transcripts, and letters of recommendation. I felt a deep sense of accomplishment and validation for all the hard work and dedication I had invested when I received a notification of a fully funded PhD scholarship from GETFund to undertake a three-year full time study at King’s College London. The scholarship not only provided financial support, which eased the burden of tuition, living and research expenses, but also offered a platform to network with other scholars and professionals, which significantly enriched my research. The GETFund PhD fellowship was a pivotal moment in my academic career, propelling me towards new heights of scholarly achievement and professional development.
What did your research at King's focus on?
My PhD was entitled ‘Development and feasibility testing of a novel community-based enhanced care intervention (CECI) to improve person-centred outcomes for people living with HIV/AIDS in Ghana’, which was informed by the Medical Research Council (MRC) guidelines for developing and evaluating complex interventions. The development of this intervention started with a review of person-centred interventions for PLWHA to ensure CECI did not duplicate an existing intervention. The findings from this review were used to inform a qualitative interview study with PLWHA and healthcare professionals published study to understand what outcomes matter to PLWHA and to use that to inform CECI development.
The components of CECI as developed consists of: (i) a training programme for healthcare professionals on person-centred communication, (ii) holistic assessment of PLWHA’s symptoms and concerns in the domains of physical, psychological, social, and spiritual wellbeing using a structured tool, (iii) a care plan to facilitate collaborative care planning and delivery, (iv) mentorship support for healthcare professions and fidelity monitoring. The CECI was then tested in a feasibility trial. The recruitment and retention targets set for the feasibility trial were met, and we also achieved small to medium potential effects, with the validated outcome measures used. These findings warrant a future definitive trial to test the effectiveness and cost-effectiveness of CECI.
What have you gone on to do in work since your PhD?
Since my PhD, I worked as a post-doctoral researcher at the University of York, where I supported two global health projects focusing on: (i). Improving Early Childhood Development in Urban Slums in Kenya funded by the British Academy; and (ii). Adapting the Community-based Health Planning and Services in rural and urban, which was a health system-strengthening study in Ghana funded by the MRC. I then got an academic post at the University of the West of Scotland as lecturer in Professional Health Studies for one year before moving on to Edinburgh Napier University in 2022, where I currently work as a lecture in Public Health and International Health and Social Care.
Can you tell us a bit about the MRC full trial that you won earlier this year?
I am thrilled to have received a research grant of £1,463,809.67 from the MRC earlier this year to continue my PhD work titled ‘ExtraCECI: A cluster randomised controlled trial of community-based person-centred enhanced care for people with HIV/AIDS in Ghana’, aiming to test the effectiveness and cost-effectiveness of CECI. Key lessons learnt during the feasibility trial of CECI will be used to refine CECI including an ‘extra’ component to be added to empower PLWHA to engage, participate and contribute to their care decisions, hence the name ‘ExtraCECI’. This is a collaboration between King’s College London, University of York, University of Ghana and the Ghana Health Service.
Where are you looking for your work and research to take you next?
I am delighted to have the opportunity to begin this study, having previously worked in healthcare in my home country Ghana, this feels like a way of giving back. I am particularly excited to be leading this project, as my ultimate dream would be to see ExtraCECI and its person-centred principles adapted as part of routine care for PLWHA and replicated to the whole health system in Ghana. If proven effective, ExtraCECI will provide decision-makers in Ghana with a context specific and evidence-based person-centred intervention with projections of costs and benefits to support HIV care delivery. This will serve as the starting point for bridging the person-centred skills gap among health professionals beyond Ghana and I will seek to collaborate with other researchers within Africa with the aim of adapting ExtraCECI for the management of other infectious diseases. Person-centred care puts the individual at the centre of their care, helping them to access the care they need, when they need it, by involving them in their own care decisions. I hope this wider trial can lead to a better quality of life for PLWHA and for other conditions in improving health outcomes globally.
How has your experience at King’s set you up for the work you’ve done since and are planning to do?
Studying at King’s gave me the opportunity to develop critical thinking, academic writing and research skills through expert supervision, which helped in developing a deeper understanding of my subject area, enabling me to conduct high-quality research. The Cicely Saunders Institute is an excellent research centre, championing innovative research and attracting researchers across the globe. This opened doors to a wide network of professionals, researchers and organisations in the field of palliative care, which has been invaluable for my future collaborations. I also gained an understanding of an interdisciplinary approach to both healthcare and research, with collaborations across various disciplines, fostering a holistic understanding of patient care that integrates medical, psychological and social aspects. These experiences, including the prestige of having a PhD from King's, equipped me to take on leadership roles and to advocate for better holistic care policies and practices for patients.