Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study

Abstract

Background Palliative care is recognised as a public health issue with the need for earlier integration in the wider healthcare system. However, research indicates that it continues to be accessed late in the course of an illness, public understanding of palliative care is limited, and common misconceptions prevail. Strategies to address this are needed in order to reduce barriers to palliative care delivery and improve access. Methods An explanatory sequential mixed methods study, comprising a cross-sectional survey and interviews was undertaken. Sociodemographic characteristics, public awareness, knowledge and perceptions of palliative care were examined and strategies to raise awareness and overcome barriers within a public health framework were identified. Survey data were analysed using SPSS v25 with factor analysis and non-parametric statistics and qualitative data were analysed using thematic analysis. Results A total of 1201 participants completed the survey (58.3% female, mean age 61 years) and 25 took part in interviews. A fifth of participants (20.1%) had previously heard about palliative care and had an accurate understanding of the term. Being female, higher educated, married, and older, increased respondents’ levels of awareness. The three most commonly held misconceptions included: Palliative care is exclusively for people who are in the last 6 months of life (55.4% answered incorrectly); A goal of palliative care is to address any psychological issues brought up by serious illness (42.2% answered incorrectly); and a goal of palliative care is to improve a person’s ability to participate in daily activities (39.6% answered incorrectly). Talking about palliative and end of life care was advocated but societal taboos restricted this occurring with exposure limited to personal experience. Conclusions Current knowledge gaps and misconceptions derived from limited ad hoc personal experiences and fear of engaging in taboo conversations may deter people from accessing integrated palliative care services early in a disease trajectory. The results indicate the need for public education programmes that move beyond merely raising awareness but provide key messages within a public health approach, which may change attitudes to palliative care thus ultimately improving end of life outcomes.

Study to Assess the Effectiveness of Simulation Technique to Overcome Misperceptions of Undergraduate Nursing Students’ About Paediatric Palliative Care

“…[15] Strategies addressing misperceptions surrounding PPC are needed to reduce barriers affecting the delivery of this type of care and improve its accessibility. [16] However, a few studies suggested strategies to overcome these erroneous representations. McIlfatrick has recently revealed a range of approaches to improve understanding of palliative care, including the traditional methods, namely, campaign information, posting leaflets, and media platforms such as newspapers, radio, television, and billboards.…”

Upstreaming advance care planning: application of health behavior change theory to understand barriers and facilitators to talking about death and dying in the community

“…[1], as calculated pre-pandemic, the highest proportional increase across the UK nation states. A recent survey conducted in 2019 indicates only a minority of the population (7%) have previously engaged in an ACP conversation [11].…”

Factors Influencing Public Awareness of and Attitudes Toward Palliative Care: A Cross-Sectional Analysis of the 2018 HINTS Data

“…It is predicted that only about 14% of patients worldwide who need it receive it ( 11 ). This might be attributable to the global lack of awareness and knowledge of palliative care among the general public [for a complete review, see ( 12 )], particularly about the benefits it can offer to patients. The prevalence of negative beliefs and attitudes toward palliative care has been deemed as another major hurdle for palliative care access [e.g., ( 13 – 15 )].…”

“…Extant literature on awareness of and attitudes toward palliative care are mainly descriptive, outlining health care professionals and the publics' awareness, attitudes and perceptions toward palliative care with mixed results [e.g., ( 12 , 21 – 25 )]. While some research found that most people had positive attitudes and good knowledge of palliative care ( 24 , 25 ), other studies found the opposite ( 12 , 21 , 23 , 26 ). Thus, it is important to address the prior inconsistent findings and further examine public awareness of and attitudes toward palliative care.…”