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

Abstract

BackgroundThe global burden of serious health-related suffering requiring palliative care has been projected to grow significantly by 2060, which indicates the imminent need for integrating palliative care into health systems globally. Moreover, research evidence has been accumulating in support of the earlier adoption of palliative care into the treatment course of serious life-threatening illnesses. However, barriers to earlier access to palliative care still remain, which might be attributable to the global lack of awareness of palliative care and the prevalence of negative perceptions and attitudes. To address this, further investigation of the influencing factors of public perceptions of palliative care is imperative to help inform and develop effective targeted public health campaigns and education messages aimed at improving views of palliative care and thereby early access.MethodsWe used data from the Health Information National Trends Survey (HINTS), a nationally representative cross-sectional survey routinely administrated by the National Cancer Institute from the United States. Specifically, we analyzed the latest palliative care data from HINTS 5 Cycle 2 data set. Sociodemographic characteristics, individual factors such as self-perceived health status, and interpersonal factors such as relationship quality were examined as predictors of public awareness of and attitudes toward palliative care. Survey data were analyzed using SPSS 26 with multiple hierarchical regression tests.ResultsResults showed that people's quality of interpersonal relationships was a significant influencing factor of their awareness of and attitudes toward palliative care. Moreover, cancer diagnosis history and perceived healthcare quality were found to jointly affect their awareness of palliative care; perceived health status and patient centeredness interacted to influence their awareness of and attitudes toward palliative care. Finally, female, non-white, and poorer people were more aware of palliative care, while female and more educated people had more favorable attitudes.ConclusionsThe quality of social relationships emerges as a significant predictor of people's awareness of and attitude toward palliative care, as treatment options and decisions of serious life-threatening illnesses often involve the patients' family. The results hold strong implications for public health campaigns and education messages aiming at changing people's views of palliative care, which ultimately improve end-of-life outcomes.

Palliative care stay room – designing, testing and evaluating a gamified social intervention to enhance palliative care awareness

“…Also, a study in the field of palliative care aimed to examine how personal and interpersonal aspects were associated with individual knowledge of and attitudes towards palliative care. The results identified that it was women who had more favourable attitudes towards palliative care [ 18 ].…”

“…Serious games – games designed to provide a learning experience – can be a strategic resource for palliative care education and awareness. They are described in the literature as a means to study and improve the health of populations in different areas, such as mental health [ 17 , 18 ]. Since the 1990s, these resources have been used in Palliative Care in education, to work on aspects of interdisciplinary communication and transmission of bad news, as well as to address the issue of advance directives [ 15 ].…”

“…Palliative care focuses on attending to human suffering, derived from a situation of serious, advanced illness [ 7 ]. By having awareness, information and knowledge, people are more willing to listen and talk about this topic and are not afraid to address, among other issues, their concerns about life and death [ 4 , 8 ].…”

“…Empathy is a multidimensional construct composed of cognitive, affective, and behavioural dimensions. Some studies point out that women register higher levels of empathy and, specifically, have a greater sensitivity and knowledge of issues related to palliative care [ 18 , 19 ]. Davis Harris [ 14 ] describes empathy as the set of constructs that include the processes of putting oneself in the other’s place and affective and non-affective responses; it is the general capacity to resonate with others emotional states irrespective of their valence - positive or negative [ 20 ].…”

What do patients think about palliative care? A national survey of hematopoietic stem cell transplant recipients

“…We used univariate linear regression models to explore factors associated with patients’ perceptions of PC (main outcome of interest). Predictors of interest were identified a priori by the research team 20 , 25 , 26 , 27 and included demographic factors (age, sex, race, ethnicity, importance of spirituality, marital status, education), clinical factors (transplant type, Karnofsky performance status, hematopoietic cell transplant-comorbidity index, disease risk, and presence and severity of graft-versus-host disease), time since transplant, transplant center, region of transplant center, familiarity with PC, knowledge of PC, perceived knowledge of PC, perceptions of PC, unmet PC needs, patient’s belief they will be cured with the transplant, symptom burden, and quality of life (physical and mental health). We assessed for collinearity between predictors using Pearson correlation coefficients and found positive collinearity between knowledge of PC (13-item survey) and perceived knowledge about PC (1 item in familiarity with PC domain) (r = .67, P < .0001).…”