Paediatric palliative care in Malaysia: Survey of knowledge base and barriers to referral

Knowledge of pediatric palliative care among medical students in Jordan: A cross-sectional study

“…Three of the studies found a lack of knowledge about PPC among physicians [ [38] , [39] , [40] ]. The first study was embraced in Canada St-Laurent-Gagnonet et al [ 38 ].…”

Nurses’ perceptions of barriers and facilitators and their associations with the quality of end‐of‐life care

“…However, a review of the literature review identified a limited number of studies addressing the barriers faced by general nurses in providing EOLC and the facilitators that enhance the quality of care provided to dying patients. Despite the demand for enhanced quality of EOLC in the hospital setting, nurses face many challenges in providing optimal EOLC, such as lack of education and knowledge (Bloomer, Endacott, O'Connor, & Cross, ; Mahtani‐Chugani, González‐Castro, de Ormijana‐Hernández, Martín‐Fernández, & de la Vega, ; O'Hara, ; Wallerstedt & Andershed, ), lack of communication and collaboration between healthcare providers and family (Mahtani‐Chugani et al., ; O'Hara, ), poor symptom management (O'Hara, ; Thompson, McClement, & Daeninck, ; Toscani, Di Giulio, Brunelli, Miccinesi, & Laquintana, ), lack of time to spend with the patient (O'Hara, Wallerstedt & Andershed, ), lack of privacy (Bloomer et al., ; Thompson et al., ), difficulties in changing the direction of care (Thompson et al., ), uncertain prognosis (Mahtani‐Chugani et al., ), families not accepting the patient's death (Chong & Khalid, ) and lack of support from ward managers and the organisation (O'Hara, ). Recently, a study conducted to examine Korean nurses’ perceived barriers to and facilitators of EOLC reported that the greatest barriers to providing optimal EOLC were family members’ refusal to accept the poor prognosis of the patient and difficulty dealing with the anger of family members; the top facilitators in the provision of EOLC were “having time to prepare the family for the patient's expected death” and “having the physician offer support for the family after the patient's death” (Lee, Choi, Kim, Kim, & Kim, ).…”

Paediatric palliative care at home: a single centre's experience

“…In a recent study, the most common barrier to referral in Malaysia was found to be the perceived lack of accessible services. (13) This study revealed the encouraging finding that some paediatricians in private practice are referring their patients for palliative home care. The small referral numbers may be a reflection of the nature of illnesses they treat.…”

“…Reluctance to refer may also be due to the uncertainty of the prognosis or the family's reluctance to accept palliative care. (13,17,18) Many patients in this study were referred when they were in the terminal stages, with 25.5% of our referral patients not living beyond two weeks, and the majority of these referred children had cancer. It was not within the scope of this study to ascertain the reason for late referrals of this population, but it is important for future research.…”