Assessment of knowledge, attitudes and practices in end-of-life care
- Author:
Teneza Maria Dolores T
;
Neri Milagros F.
;
Reandelar Jr. Macario F.
- Publication Type:Journal Article
- MeSH:
ATTITUDE;
PATIENT CARE;
TERMINAL CARE
- From:
The Filipino Family Physician
2006;44(4):135-155
- CountryPhilippines
- Language:English
-
Abstract:
Objectives: A cross-sectional study was conducted to describe the relationship of the resident physicians' knowledge, attitudes and practices on end-of-life and demographic features, medical specialty, formal training on care of the dying, personal and clinical experience on care of the dying patients.
Methods: A total of 67 resident trainees participated in the study. They were asked to answer the K-A-P questionnaire on end-of-life care. The data gathered were tallied using Microsoft Excel and analyzed using SPSS 10.0 statistical software.
Results: More than half of the respondents have adequate knowledge (52.2 percent), positive attitude (53.7 percent), and have appropriate practices (53.7 percent). Nearly half (49.3 percent and 44.8 percent) of the resident physicians regarded themselves as satisfactory in knowledge and attitudes, nearly half (44.8 percent) and a third (38.8 percent) of the residents respectively assessed themselves as fair and satisfactory in end-of-life care practices. Using chi-square test, the relationship between the different physicians' characteristics and their knowledge, attitudes and practices was assessed. Males had adequate knowledge (68.2 percent) than females (44.4 percent) (p=0.068). More married individuals (77.7 percent) had positive attitude and appropriate practices than single individuals (50.0 percent) (p=0.167). Nearly two-thirds (63.3 percent) of third year and higher residents had positive attitude and appropriate practices than first and second year residents (45.9 percent) (p=0.156). More than two-thirds (66.7%) of those with formal training had more appropriate practices than those without formal training (46.5 percent) (p=0.113). No significant association between end-of-life care knowledge-attitudes-practices and these aforementioned physicians' characteristics was observed. In all other characteristics, relationship was far from being statistically significant. For knowledge, ENT-HNS, Family Medicine and Surgery residents had the most residents with adequate knowledge. The difference in the proportion of residents' knowledge across medical specialties was statistically significant (p=0.055). For attitude, Family Medicine, Obstetrics and Gynecology and Surgery had the most residents with positive attitude. The difference though was not statistically significant (p=0.156). For practices, Family Medicine, Child Health and Surgery had the most residents with appropriate practices. Here, the difference was statistically significant (p=0.010). Because of inadequate sample size however, chi-square test for these associations may not be valid. Those with personal experience with death of a loved one or a close friend (61.2 percent) had appropriate practice in end-of-life care than those without (33.3 percent). The difference was statistically significant (p=0.042). More of those with clinical experience on care of dying patients had appropriate practices (59.3 percent) than those without (30.8 percent). The difference was almost statistically significant (p=0.064). Among those residents with more than three years of clinical practice, 81.8 percent had positive attitude compared to only 45.5 percent both for less than two and 2-3 years of clinical practice. The difference likewise was of borderline significance (p=0.097). Lastly, relationship between the physician's own assessment of their knowledge, attitudes and practices and their actual knowledge, attitudes and practices Was also assessed using the same statistical test. Actual and personal assessment of end-of-life care, residents who rated themselves as either having a very satisfactory and satisfactory knowledge, attitudes and practices in end-of-life care had higher proportion of actual adequate knowledge, positive attitude and appropriate practices.
