Improvable Education in Palliative Care A Qualitative Research About Palliative Care Education From the Perspective of Young Physicians

Abstract

Background Due to i.e. demographic changes, an aging society and the increasing prevalence of non-communicable diseases, Palliative Care has become a relevant topic worldwide. The need for Palliative Care in Armenia is faced with inadequate care. (Undergraduate) education marks a major barrier to provide sufficient care and remains deficient. This research aimed to assess the current status of Palliative Care (undergraduate education) in Armenia and identify issues that need to be addressed. Methods Twenty Armenian first-year residents with different specializations were questioned in July – September 2016 regarding understanding/knowledge, experiences, self-perception of competence and expectations of Palliative Care and Palliative Care (undergraduate) education. These semi-structured interviews resulted in complete transcripts which were analyzed in a summarizing Qualitative Content Analysis subsequently. Results According to the interviews, Armenia’s health care system lacked sufficient Palliative Care and Palliative Care (undergraduate) education. Some topics, included in different subjects, only partially provided a clear understanding of typical Palliative Care patients/symptoms, approaches of incurable patients and missing training on breaking bad news. Challenges included emotional difficulties, communication of diagnosis/prognosis, uninformed patients and feared consequences for patients, families and physicians. Self-confidence in treating incurable patients varied. Stated wishes included increasing availability and accessibility of Palliative Care and extension of education in all levels (undergraduate, postgraduate, specialization). Conclusions Missing education resulted in misconceptions and ignorance of common Palliative Care concepts, expandable confidence in such situations and widely individual, varying, non-standardized approaches towards incurable patients. Palliative Care education needs to be implemented and expanded in Armenia. This research may set a base for further exploration in this field. It can be assumed that these specific results are also applicable to Palliative Care Education in other countries of the Caucasus region and beyond.