Residents' attitudes and beliefs towards palliative care in a community teaching hospital.

Abstract

89 Background: Early integrated palliative care improves the quality of life in patients with cancer. Wong et al. (2016) recently demonstrated that residents and fellows in a university hospital-based large comprehensive cancer center believed palliative care services to be beneficial for patient care. However, there are substantial differences between the clinical learning environments of a university and community teaching hospital. We aim to assess residents' attitudes and beliefs towards palliative care in the oncologic population in a community teaching hospital. Methods: We surveyed all residents (n = 90) in Mercy Catholic Medical Center's internal medicine, transitional year, and general surgery residencies about their knowledge, training, attitudes and beliefs regarding palliative care using a survey modified from Wong et al. (2015). Mercy Catholic Medical Center is a conglomeration of two community teaching hospitals in greater Philadelphia. The factors associated with awareness were analyzed using chi square or fisher exact test and logistic regression. Results: A total of 57 (63%) residents participated. The differences between the knowledge of residents from other specialties were not statistically significant. The awareness was reported more among residents who are American medical graduates (p = 0.03). The majority of the residents believed palliative care was beneficial to patients and families (98%), reduce health care costs (91%), decrease overall symptom burden (86%) and symptomatic management in newly diagnosed cancer (81%). Residents who reported having palliative care training during residency had significantly higher awareness (OR = 2.99, p = 0.04). Conclusions: Our study shows that the attitude and belief of residents at community teaching hospital is similar to the trainees at university teaching hospital. The implementation of palliative care rotation for all residents from clinical specialties can be effective in improving trainee’s attitude and belief regarding increased and early referral to palliative care.