Department of Pharmacy, Clinical & Administrative Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
Cancer Epidemiol Biomarkers Prev. 2021 Jul;30(7):1433-1439. doi: 10.1158/1055-9965.EPI-20-1790. Epub 2021 Jun 4.
Palliative care plays an important role in improving the quality of life for patients with cancer and their caregivers and has been associated with increased patient satisfaction. However, palliative care knowledge in the general population is limited, and often physician referral occurs late in prognosis. The objective of this analysis was to examine factors associated with palliative care knowledge.
Using data from the 2018 NCI's Health Information National Trends Survey (HINTS) 5 Cycle 2, descriptive statistics, bivariate analyses, and multivariable logistic regressions were used to assess factors associated with respondents' palliative care knowledge using ORs and 95% confidence intervals as measures of association. The outcome of interest was measured with the item "How would you describe your level of knowledge about palliative care?" Possible response selections were "I've never heard of it," "I know a little bit about palliative care," and "I know what palliative care is and could explain it to someone else." To reduce the risk of type 1 error, jackknife variance estimations with repeated replications were used. All analyses were conducted with the SURVEYLOGISTIC command using SAS 9.4 (SAS Institute Inc.), and the statistical significance level was set at < 0.05.
A total of 3,450 respondents (weighted sample size: 249,489,772) met the inclusion criteria. About 89% ( = 3,000) of all respondents had inadequate knowledge of palliative care. Multivariable analyses indicated that frequent health care utilization as defined as ≥ 2 times per year [OR, 3.01; 95% confidence interval (CI), 2.65-3.58], female gender (OR, 2.15; 95% CI, 1.31-3.59), being married (OR, 2.02; 95% CI, 1.14-3.59), having a college degree or higher (OR, 13.83; 95% CI, 1.71-12.04), and having a regular source of care (OR, 2.67; 95% CI, 1.37-1.90) had greater odds of adequate palliative care knowledge. Those without a cancer diagnosis were less likely to have adequate knowledge of palliative care (OR, 0.49; 95% CI, 0.41-0.89).
Knowledge of palliative care in the United States is low, particularly for those not already actively using their available healthcare system. Public health education efforts are needed to target subgroups of the U.S. population identified by this analysis to increase palliative care knowledge.
Healthcare providers have a major role to play in improving palliative care knowledge.
姑息治疗在提高癌症患者及其照顾者的生活质量方面发挥着重要作用，并与患者满意度的提高有关。然而，普通人群对姑息治疗的知识有限，并且通常在预后晚期才由医生转诊。本分析的目的是探讨与姑息治疗知识相关的因素。
使用 2018 年 NCI 的健康信息国家趋势调查（HINTS）5 周期 2 的数据，采用描述性统计、双变量分析和多变量逻辑回归，使用 OR 和 95%置信区间作为关联的度量，评估与受访者姑息治疗知识相关的因素。感兴趣的结果是使用项目“您如何描述您对姑息治疗的了解程度？”来衡量的。可能的反应选择是“我从未听说过它”，“我对姑息治疗略知一二”和“我知道姑息治疗是什么，可以向其他人解释”。为了降低第一类错误的风险，使用重复复制的 Jackknife 方差估计。所有分析均使用 SAS 9.4（SAS Institute Inc.）中的 SURVEYLOGISTIC 命令进行，并将统计学显着性水平设置为 < 0.05。
共有 3450 名受访者（加权样本量：249489772）符合纳入标准。约 89%（=3000）的所有受访者对姑息治疗知识不足。多变量分析表明，定义为每年≥2 次的频繁医疗保健利用率[OR，3.01；95%置信区间（CI），2.65-3.58]，女性（OR，2.15；95% CI，1.31-3.59），已婚（OR，2.02；95% CI，1.14-3.59），具有大学学历或更高学历（OR，13.83；95% CI，1.71-12.04），并且有固定的医疗来源（OR，2.67；95% CI，1.37-1.90）的人更有可能具有足够的姑息治疗知识。没有癌症诊断的人不太可能有足够的姑息治疗知识（OR，0.49；95% CI，0.41-0.89）。
美国姑息治疗知识水平较低，尤其是对于那些尚未积极利用现有医疗保健系统的人群。需要开展公共卫生教育活动，针对本分析确定的美国人口亚群，以提高姑息治疗知识。
医疗保健提供者在提高姑息治疗知识方面发挥着重要作用。
