Abstract
BackgroundContinual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs) among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs.MethodsThis cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155). We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs.ResultsWe found that the physicians who were aware of the World Health Organization (WHO) analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79) more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness.ConclusionBasic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.
Highlights
Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness
In 2003, a national survey asked 3,147 Japanese physicians, including those working in all the palliative care units (PCUs) and those randomly selected from all hospitals and clinics, about the World Health Organization analgesic ladder (WHO Ladder)[5]
Continual collaboration with the palliative care teams (PCTs) In response to the question, "What do you think about collaboration with the PCT?", one participant (0.6%) answered "I want to treat and care for my patients without collaboration" (1), 82 (52.9%) responded "I want to treat and care for my patients until the end, but I want to collaborate with the PCT" (2), 42 (27.1%) endorsed "I want to treat and care for my patients until the end, but I want the PCT to be in charge" (3), 20 (12.9%) said "I want to leave the responsibility to the PCT" (4), and 10 (6.5%) said that they did not know or did not respond
Summary
Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. The traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs) among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Among the more than 1 million Japanese who die from various causes every year, over 320,000 (about 32%) succumb to cancer, which has been the leading cause of death since 1981[1]. Japanese medical specialists undergo no systematic training about the introduction of palliative care. The Ministry of Health, Labour and Welfare indicated in 2007 that all physicians who treat cancer must become educated in basic palliative care within the 10 years[7]
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