Influencing factors of knowledge, attitude and behavior in children’s palliative care among pediatric healthcare workers: a cross-sectional survey in China

Abstract

Background Palliative care has become a key medical field worldwide. Although research relating to adult palliative care is well-established, less is known about children’s palliative care (CPC). Therefore, this study investigated the knowledge, attitude and behavior of pediatric healthcare workers (PHWs) regarding CPC and analyzed the influencing factors for the implementation and development of CPC. Methods A cross-sectional survey of 407 PHWs was carried out in a Chinese province from November 2021 to April 2022. The questionnaire consisted of two parts: a general information form and questions on the knowledge, attitude and behavior of PHWs about CPC. Data were analyzed using t-test, ANOVA and multiple regression analysis. Results The total score of the PHWs’ knowledge, attitude and behavior about CPC was 69.98, which was at a moderate level. PHWs’ CPC knowledge, attitude, and behavior are positively correlated.The most important influencing factors were working years, highest education, professional title, job position, marital status, religion, grade of hospital (I, II or III), type of medical institution, experience of caring for a terminally ill child/kinsfolk and total hours of CPC education and training received. Conclusions In this study, PHWs in a Chinese province had the lowest scores on the knowledge dimension of CPC, with moderate attitude and behavior and various influencing factors. In addition to professional title, highest education and working years, it is also worth noting that the type of medical institution and marital status also affected the score. Continuing education and training of PHWs in CPC should be emphasized by the administrators of relevant colleges and medical institutions. Future research should start with the above-mentioned influencing factors and focus on setting up targeted training courses and evaluating the post-training effects.

Chinese and Belgian pediatricians’ perspectives toward pediatric palliative care: an online survey

“…Specifically, in our study, Chinese pediatricians reported that they lacked supportive policies/guidelines for PPC implementation. This was consistent with Zhu et al who also reported a lack of supportive PPC policies/guidelines for healthcare providers [ 30 ]. A survey study [ 28 ] and a secondary data analysis study [ 25 ] identified lack of supportive policies/guidelines as the largest barrier to PPC implementation in Mainland China.…”

“…Hence, improving unit support where pediatricians work could facilitate PPC implementations. A previous Chinese survey study found that healthcare providers working in modern, well-equipped facilities having advanced medical resources were more likely to have opportunities to practice PPC [ 30 ]. Additionally, two other qualitative studies stressed the importance of unit support on PPC implementation.…”

“…Furthermore, access to PPC is limited, being mainly available in more developed regions [ 28 ]. Therefore, many Chinese pediatricians have poor knowledge about PPC [ 30 ]. For instance, they find the definition and goals of PPC to be unclear.…”

“…PPC there is almost exclusively implemented in hospital-based oncology wards [ 27 ]. Available literature indicates that Chinese pediatricians do not receive much professional support, even though PPC is in high demand [ 25 , 29 , 30 ].…”

Differences in the knowledge, attitudes, and needs of caregivers and healthcare providers regarding palliative care: a cross-sectional investigation in pediatric settings in China

“…Moreover, the use of palliative care services for patients remains low, and a systematic understanding of the assessment content and tools required for palliative care needs is lacking [ 5 , 6 ]. Compared with other countries, the practice of PPC in China is in its early stages; thus, service resources are insufficient, and the service model is relatively simple [ 7 ]. Preliminary exploration efforts began in Beijing, Shanghai, Chengdu, Changsha, and other cities, in addition to Hong Kong, Macao, and Taiwan [ 8 ].…”