Knowledge of and Barriers to Palliative Care Perceived by Healthcare Providers before and after Promotion of the Patient Autonomy Act: A Cross-Sectional Study

Abstract

This study was designed to investigate healthcare providers’ knowledge of palliative care and perceptions of palliative care barriers before and after promoting the Patient Autonomy Act (PAA). A convenience sample was recruited, including 277 healthcare providers in 2013 and 222 healthcare providers in 2018. Multivariate linear regression analyses were used to identify predictors of knowledge of and perceived barriers to palliative care. A principal component analysis was carried out to identify the most appropriate factorial structure for the contents of knowledge and perceived barriers to palliative care. Three factors related to knowledge of palliative care were identified in both 2013 and 2018 data: ‘policy, regulation, and promotion’, ‘philosophy and treatments’, and ‘myths and misunderstandings’. Study findings for the two periods were similar. As for barriers to providing palliative care, three factors were identified for 2013: ‘quality care’, ‘difficulties’ and ‘communication’, and for 2018, ‘information’, ‘attitudes’ and ‘quality care’ were identified. Study findings differed between the two periods. Policies can better reinforce mitigating strategies—including opportunities for education, shared decision making, and changes in institutions and care systems. Additionally, assessing barriers creates important opportunities for further research to address the most critical aspects in improving end-of-life care for patients and their families.

From Survey Results to a Decision-Making Matrix for Strategic Planning in Healthcare: The Case of Clinical Pathways

“…This is probably due to the fact that, regarding the continuity of care for patients affected by both DSA and SARS-CoV-2, the number of cases was small, and it was not necessary to create separate pathways and/or wards [14], whereas the continuity of oncological care was, in any case, guaranteed thanks to the use of protective devices, pre-triage of patients accessing the hospital, delay of non-urgent visits, and use of telemedicine for patients' follow-up, in addition to periodical rhino-pharyngeal swabs for SARS-CoV-2 testing in healthcare workers [18][19][20]. It is interesting, however, how the literature reports a gap in the knowledge of palliative care [23] and that a higher education leads to higher chances of survival in some typologies of cancer [24].…”