Physician Perceptions Toward Palliative Care Integration in Childhood Cancer Care in Asia Pacific.
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Salek Marta, Cuviello Andrea, Handayani Sri Andini, Blair Sally, Chandra Anjali, Job Godwin, Ehrlich Bella S, Chong Lee Ai, Bagai Poonam, Bee Ong Gek, Bravo Shella, Buang Siti Nur Hanim, Thi Thanh Bui Huyen, Chandra Lynna, Choden Tashi, Drake Ross, Giri Bishnu Rath, Graetz Dylan E, Gunasekera Sanjeeva, Gupta Haresh, Poh Heng Chong, Kakazu Mariko, Kang Sung Han, Kaye Erica C, Khaiman Chusana, Khaing Aye Aye, Kim Min Sun, Kurniati Nia, Laughton Stephen, do R Leão Lurdes Maria, Mahajan Amita, Miranda Michelle Cristine, Mlis Ratha, Moe Thida, Mynak Mimi Lhamu, Ngoc Lan Bui, Nguyen Hoa Thi Kim, Quintero Ximena Garcia, Rasheed Eman, Rios Diana, Dos Santos Milena Maria Lay, Sapkota Sudhir, Sari Teny Tjitra, Sharma Krishna Sagar, Sipai Sani, Sorrosa Rojim, Souvalansy Bounpalisone, Sripornsawan Pornpun, Tabjaroen Sommaphun, Tan Teresa Shu Zhen, Teh Kok Hoi, Wahyuni Rina, Watanabe Kazuyo, Yadana Su, Yi Yi Wynn, Yotani Nobuyuki, Zaki Maziya Abbas, Devidas Meenakshi, Baker Justin N, McNeil Michael J, Agulnik Asya, Lam Catherine G
Аннотация
METHODS: The validated Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in AP, translated into six languages, and adapted for cultural relevance. The survey was distributed electronically between February 2022 and February 2024 to physicians caring for children with cancer in 18 AP countries. The primary outcome was alignment with WHO PC guidance, calculated as a mean percentage per physician. Secondary analyses explored associations between demographic variables and WHO alignment scores using regression analyses. Open-ended responses were analyzed qualitatively.
RESULTS: A total of 621 physicians from 18 countries participated (median country response rate 30%; range, 11%-85% per country). Most (70%; n = 432) had >10 years of clinical experience and no prior PC training (65%; n = 401). Although 57% (n = 352) had access to pediatric PC experts, only 50% (n = 308), 36% (n = 221), 27% (n = 166), and 34% (n = 209) expressed comfort addressing patient/family physical, emotional, spiritual, and grief/bereavement needs, respectively. Additionally, 40% (n = 248) reported feeling burdened addressing end-of-life suffering. The mean alignment with WHO guidance was 76% (range, 48%-92%). Almost all (>90%; n = 570) desired further PC training.
CONCLUSION: Study findings demonstrate that most physicians in AP expressed discomfort with providing core components of PC to patients with cancer and their families. This study signals the urgent need for focused expansion of PC services and training and identifies regional opportunities to improve PC education, research, and advocacy efforts.