Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Institute of Biomedical Ethics, University of Basel, Basel, Switzerland.
J Pain Symptom Manage. 2019 Dec;58(6):1056-1067. doi: 10.1016/j.jpainsymman.2019.07.030. Epub 2019 Aug 10.
Palliative care (PC) is associated with increased quality of life for individuals with life-limiting illnesses. Despite growing recognition of the need for public advocacy and involvement, data on public perception of PC are limited. We sought to examine patterns of beliefs, sociodemographic differences, and the impact of information source on perceptions of PC.
Data were analyzed from the 2018 Health Information National Trends Survey, a representative sample of public knowledge on cancer-related information. Prevalence of perceptions was estimated among adults who self-identified as knowledgeable about PC; multivariable logistic regression invoking stepwise variable selection was used to determine associations with perceptions.
Overall, 42.5% automatically thought of death when thinking about PC, and 31.7% equate PC with hospice care. Lower proportions perceived PC as incompatible with curative medical therapy: 15.1% believed PC means giving up, and 14.5% believed PC requires the discontinuation of other treatments. Perceptions varied by age, race, education attainment, income, and marital status. In adjusted models, source of PC information was not related to differences in PC perception: PC is giving up (P ≥ 0.28), requirement to stop curative therapy (P ≥ 0.07), and equation with hospice care (P ≥ 0.29).
Six in every 10 American adults knowledgeable about PC have at least one documented misperception, with differential beliefs by sociodemographic groups. Source of information had little impact on PC beliefs. These findings may help focus future measures to educate the public about the role of PC in health care and address gaps in knowledge.
姑息治疗（PC）可提高患有绝症的个体的生活质量。尽管越来越认识到需要进行公众宣传和参与，但有关公众对 PC 的看法的数据有限。我们旨在检查信念模式、社会人口统计学差异以及信息来源对 PC 看法的影响。
对 2018 年健康信息国家趋势调查的数据进行了分析，该调查是公众对癌症相关信息的代表性知识样本。在自我认定为了解 PC 的成年人中，估计了对 PC 的看法的流行率；使用逐步变量选择的多变量逻辑回归来确定与看法相关的因素。
总体而言，42.5%的人在想到 PC 时会自动想到死亡，而 31.7%的人将 PC 等同于临终关怀。认为 PC 与根治性医学治疗不相容的比例较低：15.1%的人认为 PC 意味着放弃，14.5%的人认为 PC 需要停止其他治疗。看法因年龄、种族、教育程度、收入和婚姻状况而异。在调整后的模型中，PC 信息来源与 PC 看法的差异无关：PC 是放弃（P≥0.28）、需要停止根治性治疗（P≥0.07）和与临终关怀等同（P≥0.29）。
每 10 名了解 PC 的美国成年人中就有 6 人至少有一个被记录的误解，社会人口统计学群体之间存在不同的信念。信息来源对 PC 信念的影响不大。这些发现可能有助于集中精力进行未来的措施，以教育公众了解 PC 在医疗保健中的作用，并解决知识差距。
