Zimmermann Camilla, Wong Joanne L, Swami Nadia, Pope Ashley, Cheng YiQin, Mathews Jean, Howell Doris, Sullivan Richard, Rodin Gary, Hannon Breffni, Moineddin Rahim, Le Lisa W
Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
Division of Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
BMJ Support Palliat Care. 2021 Oct 7. doi: 10.1136/bmjspcare-2021-003340.
WHO recommends early integration of palliative care alongside usual care to improve quality of life, although misunderstanding of palliative care may impede this. We compared the public's perceived and actual knowledge of palliative care, and examined the relationship of this knowledge to attitudes concerning palliative care.
We analysed data from a survey of a representative sample of the Canadian public, accessed through a survey panel in May-June 2019. We compared high perceived knowledge ('know what palliative care is and could explain it') with actual knowledge of the WHO definition (knew ≥5/8 components, including that palliative care can be provided early in the illness and together with life-prolonging treatments), and examined their associations with attitudes to palliative care.
Of 1518 adult participants residing in Canada, 45% had high perceived knowledge, of whom 46% had high actual knowledge. Participants with high (vs low) perceived knowledge were more likely to associate palliative care with end-of-life care (adjusted OR 2.15 (95% CI 1.66 to 2.79), p<0.0001) and less likely to believe it offered hope (0.62 (95% CI 0.47 to 0.81), p=0.0004). Conversely, participants with high (vs low) actual knowledge were less likely to find palliative care fearful (0.67 (95% CI 0.52 to 0.86), p=0.002) or depressing (0.72 (95% CI 0.56 to 0.93), p=0.01) and more likely to believe it offered hope (1.88 (95% CI 1.46 to 2.43), p<0.0001).
Stigma regarding palliative care may be perpetuated by those who falsely believe they understand its meaning. Public health education is needed to increase knowledge about palliative care, promote its early integration and counter false assumptions.
世界卫生组织建议在常规护理的同时尽早整合姑息治疗以提高生活质量，尽管对姑息治疗的误解可能会阻碍这一进程。我们比较了公众对姑息治疗的认知知识和实际知识，并研究了这些知识与对姑息治疗态度之间的关系。
我们分析了2019年5月至6月通过调查小组对加拿大公众代表性样本进行调查的数据。我们将高认知知识（“知道姑息治疗是什么并能解释”）与世界卫生组织定义的实际知识（知道≥5/8个组成部分，包括姑息治疗可在疾病早期提供并与延长生命的治疗一起提供）进行比较，并研究它们与姑息治疗态度的关联。
在居住在加拿大的1518名成年参与者中，45%有高认知知识，其中46%有高实际知识。认知知识高（与低相比）的参与者更有可能将姑息治疗与临终关怀联系起来（调整后的比值比为2.15（95%置信区间为1.66至2.79），p<0.0001），且不太可能认为它能带来希望（0.62（95%置信区间为0.47至0.81），p=0.0004）。相反，实际知识高（与低相比）的参与者不太可能觉得姑息治疗可怕（0.67（95%置信区间为0.52至0.86），p=0.002）或令人沮丧（0.72（95%置信区间为0.56至0.93），p=0.01），更有可能认为它能带来希望（1.88（95%置信区间为1.46至2.43），p<0.0001）。
那些错误地认为自己理解姑息治疗含义之人可能会使对姑息治疗的污名化持续存在。需要开展公共卫生教育以增加对姑息治疗的了解，促进其早期整合并消除错误观念。
