1.A multicenter study on the gaps and potential barriers in palliative care services
Dan Robert S. Mariano ; Ma. Teresa Tricia Guison-Bautista
The Filipino Family Physician 2020;58(2):162-167
Background and Objective:
Palliative care is a human right. In the local setting, only a few data have been published regarding its practice among healthcare workers. This study aimed to determine the gaps and potential barriers in palliative care services among resident physicians.
Methodology:
A cross-sectional study design using a 27-item interview-based questionnaire was conducted from July to September 2019 among resident trainees in seven departments of four hospitals in Manila, Philippines. The data gathered were tallied using Microsoft Excel and analyzed using STATA Statistical Software with p-value of 0.05 as statistically significant.
Results:
A total of 200 physicians participated in the study. Majority of the respondents referred patients to palliative care services, primarily for symptom control and home care upon the diagnosis of a terminal illness. Sixty percent of respondents correctly identified patients eligible for hospice care. The 3 services rated as most important in palliative care were pain control, symptom control and psychological support. Most of the respondents perceived that palliative care is underutilized, and yet they felt that attending doctors know when referral to such is appropriate. The discrepancy is due to their lack of knowledge on the nature of its scope of care and eligibility criteria. The common barriers for referral to palliative care were “no time to refer secondary to rapid demise of the patient”, “difficulty in accurately predicting death”, and “lack of time to discuss issues of dying and hospice care”. These presumed barriers contradicted the respondents’ perceived practices in advance care planning, particularly on confirming the goals of treatment with the patient and family.
Conclusion
The prevailing illiteracy on palliative care that poorly translates to actualization is alarming as it deprives many patients of their right to a dignified and quality of life given their limited days. The inexcusable lack of awareness must be the impetus to a massive knowledge drive to impact clinical practice.
Hospices
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Physicians