Heard Of Palliative Care Research Articles

Knowledge and awareness of undergraduate medical students regarding palliative care in Pakistan: a cross-sectional study.

Our study assesses the current knowledge and prior awareness of undergraduate medical students in Pakistan regarding palliative care. This descriptive Cross-sectional online survey was distributed among undergraduate medical students across Pakistan, with a sample size of 246 participants. The questionnaire, adapted from the PaCKS questionnaire by Kozlov et al. (JAMA 15(5):524-34, 2017), was designed to assess the students' prior knowledge about palliative care. The mean PaCKS score was 9.7 out of 13, with a standard deviation of 2.76. Having heard of palliative care before participation in the study was significantly associated with higher PaCKS scores. Key factors associated with a higher incidence of prior awareness of palliative care included attending private institutions, being in a more advanced year of study, and having a higher mean monthly family income (P < 0.001 for each factor). This study explores medical students' understanding of palliative care in Pakistan, finding that while many have a basic grasp of the concept, there are notable misconceptions, particularly in differentiating palliative care from hospice care and understanding its broader role. Interestingly, students' knowledge did not significantly improve as they advanced through medical school, suggesting potential shortcomings in the curriculum. The findings highlight the need for more precise education and targeted training to better equip future healthcare providers for delivering patient-centered care.

Perceptions of Palliative Care Among Patients With Kidney Allograft Dysfunction: A Qualitative Study

Rationale & ObjectiveNearly half of kidney transplant recipients develop allograft failure within 10 years of transplantation and experience high mortality, significant symptom burden, and complex communication challenges. These patients may benefit from palliative care, but palliative care is infrequently provided in this population. This study explores palliative care perceptions and needs among patients with poorly functioning and declining kidney allografts. Study DesignQualitative study using semi-structured interviews. Setting & ParticipantsAdult kidney transplant recipients with a glomerular filtration rate <20 ml/min/1.73m2 followed at a single transplant center were interviewed from April to November 2022. Analytical ApproachAn interdisciplinary team, including nephrology, palliative care, and surgery, conducted a thematic analysis. ResultsTwelve participants (3 women, 9 men; 9 White, 2 Black, and 1 Hispanic patient) were interviewed. The median age of participants was 59 (IQR 48-73). At six months post-interview, seven participants had resumed dialysis, one participant had been retransplanted, and one participant was deceased. Most participants had not heard of palliative care and those who had equated it with end-of-life care. Participants reported that emotional distress, particularly pervasive concern about the worsening of their kidney disease, was their most significant priority related to unmet palliative care needs. They also desired more discussion with their care team about future quality-of-life and lifespan. Participants described high trust in their transplant teams, suggesting that palliative care integration with these teams would be well-received. LimitationsLimitations include recruitment from a single institution, lack of subject familiarity with palliative care, and limited racial and ethnic diversity among participants. ConclusionsPatients with declining kidney allografts have heterogeneous, unmet palliative care needs, including emotional symptoms and a desire for better prognostic awareness. Our results suggest that patients are largely unaware of palliative care and may benefit from practice models in which transplant teams integrate palliative care education and timely palliative care engagement.

Palliative care knowledge and access among people with small cell lung cancer and their family caregivers: Preliminary findings.

197 Background: People with small cell lung cancer (SCLC) make up 13-15% of those diagnosed with lung cancer. Although current statistics show the 5-year survival rate of people with lung cancer has improved overall, this is not the case for those diagnosed with SCLC. The disease is rapidly growing and aggressive, making access to palliative care crucial for improving quality of life for both people with SCLC and their family members. We developed a survey to assess palliative care knowledge and access among people with small cell lung cancer and their family caregivers. Methods: An online cross-sectional survey was conducted by the Lung Cancer Registry from GO2 for Lung Cancer (lungcancerregistry.org) from June 2023-present and included questions regarding treatment decision making, palliative care, and access to care. The SCLC survey is promoted to current Lung Cancer Registry participants who indicated a diagnosis of SCLC or were a family caregiver of someone with SCLC. Both people with SCLC and their family caregivers are eligible to participate in the survey. We also recruited people with SCLC through additional targeted online recruitment, direct outreach to community hospitals, and healthcare providers. Descriptive statistics were used to summarize survey findings. Results: As of May 2024, the SCLC survey was completed by 20 participants (mean age, 62 years; White, 85.0%; female, 55.0%; diagnosed with SCLC, 95.0%). Over half of people with SCLC (n = 11, 55.0%) had a family caregiver. While most participants had heard of palliative care (n = 15, 75.0%), less than half (n = 9, 45.0%) were offered or given information about it. Half of participants (n = 10, 50.0%) received or indicated they would like to receive palliative care. When asked what was needed from palliative care amongst these individuals, medication management for pain and physical symptoms was the top response (26.9%). For those who did not receive or would not like to receive palliative care, the top reasons included that it was not offered to them (26.7%) and wanting to learn more about it first to guide their decision-making (20.0%). Lastly, when asked what type of palliative care support was needed, emotional support was the top response (27.3%) followed by information on coping with lung cancer (24.2%). Conclusions: Preliminary findings suggest efforts are needed by care teams to expand access and improve education regarding palliative care among people with SCLC and their family caregivers. The fast-growing, aggressive nature of SCLC makes it especially urgent that care teams reach and meet the needs of this population. Our findings thus far highlight the need for additional research with larger sample sizes to ensure generalizability for the small cell lung cancer community.

Advance directives among community-dwelling stroke survivors.

Advance directives (ADs) are integral to health care, allowing patients to specify surrogate decision-makers and treatment preferences in case of loss of capacity. The present study sought to identify determinants of ADs among stroke survivors. In this cross-sectional study (Care Attitudes and Preferences in Stroke Survivors [CAPriSS]), community-dwelling stroke survivors were surveyed on ADs; validated scales were used to query palliative care knowledge and attitudes towards life-sustaining treatments. Logistic regression was used to determine variables associated with ADs. Among 562 community-dwelling stroke survivors who entered the survey after screening questions confirmed eligibility, 421 (74.9%) completed survey components with relevant variables of interest. The median age was 69 years (IQR 58-75 years); 53.7% were male; and 15.0% were Black. Two hundred and fifty-one (59.6%) respondents had ADs. Compared to stroke survivors without ADs, those with ADs were more likely to be older (median age 72 vs. 61 years; p<0.001), White (91.2% vs. 75.9%, p<0.001), and male (58.6% vs. 46.5%, p = 0.015), and reported higher education (p<0.001) and income (p = 0.011). Ninety-eight (23.3%) participants had "never heard of palliative care". Compared to participants without ADs, participants with ADs had higher Palliative Care Knowledge Scale (PaCKS) scores (median 10 [IQR 5-12] vs. 7 [IQR 0-11], p<0.001), and lower scores on the Attitudes Towards Life-Sustaining Treatments Scale (indicating a more negative attitude towards life-sustaining treatments; median 23 [IQR 18-28] vs. 29 [IQR 24-35], p<0.001). Multivariable logistic regression identified age (OR 1.62 per 10 year increase, 95% CI 1.30-2.02; p<0.001), prior advance care planning discussion with a physician (OR 1.73, 95% CI 1.04-2.86; p = 0.034), PaCKS scores (OR 1.06 per 1 point increase, 95% CI 1.01-1.12; p = 0.018), and Attitudes Towards Life-Sustaining Treatments Scale scores (OR 0.91 per 1 point increase, 95% CI 0.88-0.95; p<0.001) as variables independently associated with ADs. Age, prior advance care planning discussion with a physician, palliative care knowledge, and attitudes towards life-sustaining treatments were independently associated with ADs.

Palliative Care Survey: Awareness, Knowledge and Views of the Styrian Population in Austria.

No population-based data on awareness and knowledge of palliative care currently exist in Austria. We therefore conducted a survey to determine the general awareness and knowledge of palliative care in Styria, a federal state in Austria. We also asked participants to imagine what services they would need as a patient or family member, where they themselves would like to receive such services, and what fears they imagined patients with a terminal illness would have. A descriptive cross-sectional survey consisting of 18 questions that address several aspects of palliative care was carried out in the adult population of Styria, Austria, from October 2019 to March 2020. A total of 419 questionnaires were analyzed, whereby 70.3% of respondents had at least heard of palliative care. Of these, significantly more were female, had a university degree and were aged 50 to 64. The main goal of palliative care was chosen correctly by 67.1% of participants, with the proportion of correct answers increasing in line with education and reaching 82.0% among university graduates. Overall, 73.2% believed that the greatest need of terminally ill persons was a reduction in physical suffering, whereas the greatest perceived need of relatives was the availability of specialist care around the clock. About one-third believed that the greatest fear of palliative patients was that of death, which was chosen significantly more often by men than women. If terminally ill, some 39% of respondents would wish to be looked after at home by professional carers, and women and people that had completed high school chose this answer significantly more often. The most desired service that should be provided to patients and relatives was home pain management at 69.9%, followed by time off for family caregivers at 58.0%. This item was chosen significantly more often by women. To facilitate the care of severely ill patients at home, it would make sense to develop targeted information campaigns. These should also attempt to deliver targeted information to less informed groups of people, such as young, poorly educated men, in order to raise their awareness of the difficulties and challenges of providing care to terminally ill patients and thus increase the acceptance of support options.

Awareness and Actual Knowledge of Palliative Care Among Older People: A Dutch National Survey.

Lack of public knowledge of palliative care may be a barrier to timely use of palliative care and hinder engagement in advance care planning (ACP). Little research has been conducted on (the relationship between) awareness and actual knowledge of palliative care. To determine awareness and actual knowledge of palliative care and explore factors that contribute to knowledge of palliative care among older people. A cross-sectional study in a representative sample of 1242 Dutch people (≥ 65 years; response 93.2%) on whether they had heard of palliative care and knowledge statements about palliative care. The majority had heard of the term palliative care (90.1%), and 47.1% reported to know (quite) exactly what it means. Most knew palliative care is not only for people with cancer (73.9%) and is not only provided in hospice facilities (60.6%). A minority knew palliative care can be provided alongside life-prolonging treatment (29.8%) and is not only for people who have a few weeks left to live (23.5%). Experience with palliative care through family, friends and/or acquaintances (range ORs: 1.35-3.39 for the four statements), higher education (ORs: 2.09-4.81), being female (ORs: 1.56-1.91), and higher income (OR: 1.93) were positively associated with one or more statements, while increasing age (ORs: 0.52-0.66) was negatively associated. Knowledge of palliative care is limited, stressing the need for population-wide interventions, including information meetings. Attention should be paid to timely attention for palliative care needs. This might stimulate ACP and raise public knowledge of (im) possibilities of palliative care.

Exploring the awareness, knowledge and perceptions of palliative care at end-of-life in a Canadian population

Background The role of palliative care (PC) in chronic disease and end-of-life (EOL) management is rapidly evolving. However, studies globally have demonstrated limited public knowledge and awareness of PC with several misconceptions. Objective The purpose was to expand upon previous Canadian studies by providing more current and detailed information about the awareness, knowledge and perceptions of PC in EOL management. Additionally, the reliability of self-reported PC knowledge was explored. Methods A cross-sectional study using an 8-item questionnaire was conducted at an urban medical centre with 100 adults. Descriptive statistics and Chi-square tests were used for analyses. Results Ninety-one participants had heard of PC, while 58 reported being knowledgeable of PC services. Females were significantly more knowledgeable than males (p < 0.05). Most participants knew that PC improves a patient’s quality of life (n = 71), would not shorten life in a dying individual (n = 71) and can be provided in locations outside of the hospital (n = 72). Many indicated that involving PC services would not make them feel like they were giving up hope. There was less awareness around when to involve PC services, as there were mixed answers to whether PC is only needed if someone is dying from an illness. Two-thirds of participants who reported being knowledgeable of PC answered at least 75% of questions correctly. Conclusion Participants were quite aware and knowledgeable of PC but would benefit from education about the PC role in both chronic disease and EOL management. Self-reported knowledge was a fairly reliable indicator of true knowledge in this study.

Adopting a palliative care mindset is an unmet need in Parkinson’s disease

IntroductionParkinson’s disease (PD) affects multiple facets of patients’ lives, many of which may not be recognized or addressed by their healthcare team. A growing body of evidence has shown that palliative care improves patients’ quality of life with PD; however, little is currently known about how patients with PD perceive palliative care. MethodsAn 8-question multiple choice survey was created and given to patients with established care for PD at a movement disorders clinic in a quaternary care center. Patients with less than two years of follow-up or that had atypical features of PD were excluded from the survey. ResultsThere were 106 respondents to the survey. A third of patients reported having never heard of palliative care and an additional 25% had heard of it but did not know what it was. Eighty-eight percent reported being familiar with or very knowledgeable about hospice, though 50% of respondents did not know the difference between hospice and palliative care. 93% had never been offered either service. 37.7% thought their neurologist should discuss advance care planning early in the course of their disease. ConclusionEven among established patients with Parkinson’s disease in a quaternary center, over half were not familiar with palliative care, and the majority had never been offered palliative or hospice services despite growing evidence that it could improve their quality of life. Additionally, patients would like to be introduced to advanced care planning early in the course of their disease.

Public interest in medical assistance in dying and palliative care

ObjectivesMedical assistance in dying (MAiD) is legal in an increasing number of countries, but there are concerns that its availability may compromise access to palliative care. We assessed public interest...

Palliative Care to the People: Partnering with a Patient Experience Department to Raise Awareness of Palliative Care in the Community (T315D)

1.Describe the development and implementation of a novel partnership between a clinical department of palliative care and a department of patient experience.2.Describe a systematic approach to developing, implementing, and evaluating a multifaceted strategy to improve palliative care awareness in the community.3.Identify novel ways to increase awareness of palliative care in the community. Over 70% of U.S. adults have never heard of palliative care (PC). Of those who have heard of PC, less than 40% know what it is and can explain it to someone else. Lack of awareness and inadequate knowledge of PC are barriers to accessing PC services. As part of a collaboration between our clinical department of palliative care and department of patient experience, we developed, implemented, and evaluated a multifaceted intervention to increase awareness about PC in the community surrounding our suburban academic medical center. Our intervention included 1) developing a web-based and social media presence, 2) hosting public-facing lectures and webinars, and 3) developing partnerships with community organizations. To measure our impact, we monitored exposure (number of individuals who viewed our content), engagement (number of individuals who participated in an event), number of community partnerships, and likelihood to recommend scores measured by a 5-point Likert scale. Over the course of 8 months, we launched a website, started a Twitter account, and posted 5 recorded lectures on YouTube. We facilitated 23 lectures, webinars, or small group discussions that included both in-person and virtual events. We developed partnerships with 2 community agencies. To date, 6870 individuals have been exposed to our content and 22% (N=1509) of those individuals engaged further by participating in an event. Of those who participated, 86% (N=1298) participated in a virtual event held during the coronavirus pandemic. Our average likelihood to recommend score was 4.2 (SD 1.3), correlating to “likely” to recommend. Partnering with a patient experience department provided our clinical PC team with the outreach expertise needed to rapidly expand our reach in raising awareness of PC in the community. Further investigation of these efforts will include evaluating changes in participants’ knowledge and attitudes about PC.

Sources of Palliative Care Knowledge Among Patients With Advanced or Metastatic Gynecologic Cancer

ContextA minority of patients with advanced or metastatic gynecologic cancer utilize palliative care and lack of knowledge may be a barrier to receiving palliative care services. ObjectivesTo identify sources used by patients with advanced or metastatic gynecologic cancer to learn about palliative care and evaluate for differences in knowledge about palliative care and palliative care utilization by knowledge source. MethodsPatients with gynecologic cancer receiving treatment for advanced or metastatic gynecologic cancer at a single academic medical center were surveyed about their awareness of and knowledge about palliative care. Medical chart review was conducted. ResultsOf the 111 women surveyed, 70 had heard of palliative care (63%). Sixty-eight specified from where they learned of palliative care: cancer care (n = 28; 41.2%), word of mouth (n = 26; 38.2%), work (n = 6; 8.8%), self-education (n = 4; 5.9%), personal experience (n = 2; 2.9%), or do not know (n = 2; 2.9%). Knowledge about palliative care (P = 0.35) and palliative care utilization (P = 0.81) did not differ by awareness of palliative care. ConclusionMost women receiving treatment for advanced gynecologic cancer have heard of palliative care from sources other than their cancer care providers. Knowledge about palliative care and source of knowledge about palliative care were not associated with palliative care utilization. Awareness of palliative care and palliative care utilization may be improved by increasing the low rate of health provider-based education and engaging cancer patients' social networks.

Sociocultural Factors Associated with Awareness of Palliative Care and Advanced Care Planning among Asian Populations.

Underutilization of palliative care (PC) among racial/ethnic minorities remains consistent despite projected demand. The purpose of this study was to examine knowledge of palliative care and advanced care planning (ACP) and potential variations among subgroups of Asian Americans. A survey was conducted to collect information about awareness, knowledge, and perspective of PC and ACP in the southwestern region of the United States, from October 2018 to February 2019. A total of 212 surveys were collected from the general public at such places as health fairs, New Year celebration events, church, and community centers; 154 surveys were included in the descriptive and multivariate data analysis. About 46.1% and 40.3% participants reported having heard of palliative care and advanced care planning, respectively. The average score of the Knowledge of Care Options Instrument (KOCO) was 6.03 out of 11 and the average score of the Palliative Care Knowledge Scale (PaCKS) was 4.38 out of 13. Among those who have heard of PC, both Chinese (odds ratio (OR) .19 [CI, .05, .73]) and Vietnamese (.22 [.06, .84]) were less likely to have heard of palliative care compared with Filipinos (1.00). Among those who have ever heard of advanced care planning, age (.60 [.43, .84]) was negatively and education level (1.91 [1.18, 3.08]) was positively associated with awareness about advanced care planning. The majority of survey participants preferred family members to serve as their power attorneys. The low levels of palliative care and advanced care planning awareness and knowledge in the diverse Asian groups living in the United States raise concerns and shed light on the critical need for culturally appropriate education programs.

Understanding of palliative care among members of the public.

71 Background: The World Health Organization (WHO) defines palliative care (PC) as an approach that improves the quality of life of patients and their families facing life-threatening illness. However, the public may be unaware of this definition. We assessed the Canadian public’s knowledge and attitudes toward PC before and after being provided the WHO definition. Methods: We engaged a health research firm to distribute a cross-sectional survey to members of the Canadian public. Eligible participants were &gt;18 years of age, could comprehend English or French, and were currently residing in Canada. We assessed participants’ knowledge of and attitudes towards PC before and after reading the WHO definition of PC. Results were analyzed using the Wilcoxon Signed-Rank test. Results: Of 1518 participants (52% female), 45% (676/1518) stated they knew what PC was and could explain it, 32% (488/1518) knew about PC but could not explain it, 13% (198/1518) had heard of PC but did not know what it was, and 10% (156/1518) had never heard of PC. Of those who had heard of PC, 58% (784/1362) agreed PC is the last resort when other treatments have failed, 64% (877/1362) agreed PC means being close to death, and 67% (914/1362) believed PC meant being at “the stage that you can no longer take care of yourself”. Before reading the WHO definition, 56% (774/1362) agreed/strongly agreed that referral to PC would make them feel afraid; after reading the definition, this percentage was reduced to 41%, and degree of fearfulness was reduced in 46% (p&lt;0.0001). Fifty-nine percent (898/1518) stated they did not know, prior to reading the WHO definition, that PC could be involved early in the course of illness, and 45% did not know PC could be provided together with other treatments aimed at prolonging life. Eighty-nine percent (1344/1518) felt the PC definition helped them to better understand what PC is, and 91% believed that Canadians should be made aware PC can be included early in the course of a patient’s illness. Conclusions: More than half of respondents had limited knowledge of PC and believed it was synonymous with end-of-life care. Provision of the WHO definition improved understanding and allayed fears of PC. Public educational initiatives may improve understanding and increase acceptance of PC.

Perceived knowledge of palliative care among immigrants to the United States: a secondary data analysis from the Health Information National Trends Survey.

Immigrants to North America receive more interventions at end of life potentially due to knowledge gaps. The primary objective of this study was to measure and describe levels of perceived knowledge about palliative care among immigrants to the United States (US) compared to those born in the US. Our secondary objective was to identify trusted sources for seeking information about palliative care among immigrants and compare these trusted sources with those born in the US. We hypothesized that immigrants would have less knowledge of palliative care than those born in US and would trust different sources for information about palliative care. We analyzed data from the nationally representative 2018 Health Information National Trends Survey (HINTS 5, cycle 2). Questionnaires were administered via mail between January and May 2018 to a population-based sample of adults. The primary outcome of interest was assessed using the item "How would you describe your level of knowledge about palliative care?" The secondary outcome of interest was determined using the item "Imagine you had a strong need to get information about palliative care, which of the following would you most trust as a source of information about palliative care?" Descriptive statistics were calculated, and bivariate analyses run between the outcomes of interest and sociodemographic characteristics (age, sex, education, race/ethnicity, nativity, fluency with English). Multivariable logistic regressions were conducted to assess the role of nativity, controlling for relevant sociodemographic variables. Jackknife weighting was used to generate population-level estimates. About 70% of those born in the US and 77% of immigrants (weighted) responded that they had "never heard of palliative care." Trusted sources of palliative care were very similar between the groups (all P>0.05). Both groups' preferred trusted source of palliative care knowledge was "health care provider," with over 80% of respondents in each group selecting this option. Printed materials and social media were the least popular trusted sources among both groups. After adjusting for relevant sociodemographic characteristics, we found no association between poor knowledge of palliative care and nativity (P=0.22). Female respondents had 2.5-fold increased odds of reporting low levels of perceived knowledge of palliative care (OR =2.58, 95% CI, 1.76-3.78; P<0.001). Education was an important predictor of perceived knowledge of palliative care; as education level increased, so did perceived knowledge of palliative care (P<0.001). Perceived knowledge of palliative care is poor generally, regardless of birthplace. Trusted sources for palliative care are similar between immigrants and those born in the US. Education is important and is a strong predictor of perceived knowledge of palliative care. Women perceive they have lower levels of knowledge of palliative care (PC) than men. Differences in end of life care between immigrants and non-immigrants cannot be explained by knowledge differences.

Knowledge of and beliefs about palliative care in a nationally-representative U.S. sample.

Palliative care aims to improve quality of life for people with serious illness and their families. One potential barrier to palliative care uptake is inaccurate knowledge and/or negative beliefs among the general population, which may inhibit early interest in, communication about, and integration of palliative care following subsequent illness diagnosis. We explored knowledge and beliefs about palliative care among the general public using nationally-representative data collected in 2018 as part of the cross-sectional Health Information National Trends Survey. Only individuals who had heard of palliative care (n = 1,162, Mage = 51.8, 64% female) were queried on knowledge and beliefs. We examined whether self-assessed level of awareness of palliative care (i.e., knowing a little vs. enough to explain it) was associated with the relative likelihood of having accurate/positive beliefs, inaccurate/negative beliefs, or responding “don’t know” to questions about palliative care. Respondents who indicated knowing a lot about palliative care had more accurate versus inaccurate knowledge than those who knew a little on only two of six items and more positive attitudes on only one of three items. In particular, respondents with greater awareness were equally likely to report that palliative care is the same as hospice and requires stopping other treatments, and equally likely to believe that palliative care means giving up and to associate palliative care with death. Those with higher awareness were less likely than those with lower awareness to respond “don’t know,” but greater awareness was not necessarily associated with having accurate or positive beliefs about palliative care as opposed to inaccurate or negative beliefs. Thus, even members of the general public who perceived themselves to know a lot about palliative care were often no less likely to report inaccurate knowledge or negative beliefs (versus accurate and positive, respectively). Findings suggest a need to improve awareness and attitudes about palliative care.

A Formative Evaluation of Patient and Family Caregiver Perspectives on Early Palliative Care in Chronic Obstructive Pulmonary Disease across Disease Severity.

Rationale: Little direction exists on how to integrate early palliative care in chronic obstructive pulmonary disease (COPD).Objectives: We sought to identify patient and family caregiver early palliative care needs across stages of COPD severity.Methods: As part of the Medical Research Council Framework developmental phase for intervention development, we conducted a formative evaluation of patients with moderate to very severe COPD (forced expiratory volume in 1 s [FEV1]/FVC < 70% and FEV1 < 80%-predicted) and their family caregivers. Validated surveys on quality of life, anxiety and depressive symptoms, and social isolation quantified symptom severity. Semi-structured interviews were analyzed for major themes on early palliative care and needs in patients and family caregivers and across COPD severity stages.Results: Patients (n = 10) were a mean (±SD) age of 60.4 (±7.5) years, 50% African American, and 70% male, with 30% having moderate COPD, 30% severe COPD, and 40% very severe COPD. Family caregivers (n = 10) were a mean age of 58.3 (±8.7) years, 40% African American, and 10% male. Overall, 30% (n = 6) of participants had poor quality of life, 45% (n = 9) had moderate-severe anxiety symptoms, 25% (n = 5) had moderate-severe depressive symptoms, and 40% (n = 8) reported social isolation. Only 30% had heard of palliative care, and most participants had misconceptions that palliative care was end-of-life care. All participants responded positively to a standardized description of early palliative care and were receptive to its integration as early as moderate stage. Five broad themes of early palliative care needs emerged: 1) coping with COPD; 2) emotional symptoms; 3) respiratory symptoms; 4) illness understanding; and 5) prognostic awareness. Coping with COPD and emotional symptoms were commonly shared early palliative care needs. Patients with very severe COPD and their family caregivers prioritized illness understanding and prognostic awareness compared with those with moderate-severe COPD.Conclusions: Patients with moderate to very severe COPD and their family caregivers found early palliative care acceptable and felt it should be integrated before end-stage. Of the five broad themes of early palliative care needs, coping with COPD and emotional symptoms were the highest priority, followed by respiratory symptoms, illness understanding, and prognostic awareness.

Cancer patients' perceptions of palliative care.

Despite clear benefits of early integration of palliative care (PC) and oncology, concerns remain about negative perceptions of PC. Our aim was to explore current knowledge and perceptions of PC in cancer patients. We conducted a prospective, cross-sectional survey. A 16-item questionnaire was distributed to all cancer patients (N = 103) upon admission to the oncology ward of an Australian tertiary academic hospital. Chi-squared test was used to examine for significant factors related to patients' perceptions. Ninety-six patients (93%) completed the questionnaire; 76% had metastatic cancer. We explored the following domains:Experience and knowledge: 76% had heard of PC; 21% had received PC. Self-rated PC knowledge was varied. Forty-five percent believed that PC was only associated with EOLC; those more likely to disagree had received PC services (p = 0.039).Integration of PC and oncology: Majority believed that they could receive oncology care (86%) and anti-cancer treatment (81%) whilst receiving PC. Those who had heard of PC and with better self-rated knowledge were more likely to believe that they could receive concurrent anti-cancer treatment (p = 0.005, p = 0.045, respectively).Feelings: 77% felt comforted with PC involvement; this was significantly associated with older age (p = 0.047) and understanding that oncology (p < 0.005) and anti-cancer treatment (p = 0.013) could continue. However, some felt frightened (40%) and hopeless (29%) about referral to PC. Fifty percent felt more comfortable with referral to 'supportive care' services (versus PC). Our survey demonstrates reasonable understanding and relatively positive feelings about PC, associated with experience and knowledge. Nonetheless, there is ongoing need for better patient and public education about PC.

What do family caregivers know about palliative care? Results from a national survey.

Despite their key role in caring for individuals with serious, chronic illness, there have been no national studies examining family caregiver awareness and perceptions of palliative care. Hence, our objectives were to ascertain level of knowledge of palliative care among U.S. family caregivers and describe demographic variation in awareness and perceptions of palliative care. Using the 2018 National Cancer Institute Health Information National Trends Survey, we identified unpaid family caregivers caring or making healthcare decisions for someone with a medical, behavioral, disability, or other condition. Respondents were asked about their awareness of the term "palliative care" and, if aware, how much they agreed with statements representing common (mis)perceptions about palliative care (e.g., "Palliative care is the same as hospice"). More than one-half of caregivers (55%) had "never heard" of palliative care; 19.2% knew what palliative care was and "could explain it to someone else." In adjusted models, racial minorities (vs. whites) and those without a college degree were less likely to have heard of palliative care. Among those aware of palliative care, ~40% "strongly" or "somewhat" agreed that "Palliative care is the same as hospice"; another 10.5% "didn't know." Similarly, 40% reported that "When I think of palliative care, I automatically think of death." One-half of family caregivers of adults with serious chronic illness have never heard of palliative care. Even among those who had heard of palliative care, the majority do not distinguish it from hospice care and death. Given the role family caregivers may play in decisions to access palliative care, public messaging efforts are needed to clarify palliative care services in a way that is patient- and family-centered.

3095 Perceived Knowledge of Palliative Care among Immigrants: A Secondary Data Analysis from the Health Information National Trends Survey

OBJECTIVES/SPECIFIC AIMS: Immigrants to North America receive more interventions at end of life.The reasons for this are not entirely clear but may potentially be due to knowledge gaps. The primary objective of this study was to measure and describe levels of perceived knowledge about palliative care among immigrants to the US compared to those born in the US. Our secondary objective was to identify trusted sources for seeking information about palliative care among immigrants and compare these trusted sources with those born in the US. We hypothesized that immigrants would have less knowledge of palliative care than those born in US and would trust different sources for information about palliative care. METHODS/STUDY POPULATION: We analyzed data from the nationally representative 2018 Health Information National Trends Survey (HINTS 5, cycle 2). Questionnaires were administered via mail between January and May 2018 to a population-based sample of adults. The primary outcome of interest was assessed using the item “How would you describe your level of knowledge about palliative care?” The secondary outcome of interest was determined using the item “Imagine you had a strong need to get information about palliative care, which of the following would you most trust as a source of information about palliative care?” All analyses were complete case analyses and conducted with survey commands using SAS 9.3 (SAS Institute Inc, Cary, NC, USA). Descriptive statistics were calculated, and bivariate analyses run between the outcomes of interest and sociodemographic characteristics (age, sex, education, race/ethnicity, nativity, English language proficiency). Multivariable logistic regressions were conducted to assess the role of nativity, controlling for statistically significant and relevant sociodemographic variables. Jackknife weighting was used to generate population-level estimates. RESULTS/ANTICIPATED RESULTS: The response rate was 33% (n=3384) and included 2846 (85.3% weighted) born in the US and 492 (14.7% weighted) not born in the USA. About 70% of those born in the US and 77% of immigrants (weighted) responded that they had “never heard of palliative care.” Trusted sources of palliative care were very similar between the groups (all p &gt; 0.05). Both groups’ preferred trusted source of palliative care knowledge was “health care provider,” with over 80% of respondents in each group selecting this option. Printed materials and social media were the least popular trusted sources among both groups. After adjusting for relevant sociodemographic characteristics, we found no association between poor knowledge of palliative care and nativity (p=0.22). Female respondents had 2.5-fold increased odds of reporting low levels of perceived knowledge of palliative care (OR = 2.58, 95% CI = 1.76-3.78; p&lt;0.001). Education was an important predictor of perceived knowledge of palliative care; as education level increased, so did perceived knowledge of palliative care (p &lt; 0.001). DISCUSSION/SIGNIFICANCE OF IMPACT: Perceived knowledge of palliative care is poor generally, regardless of birthplace. Trusted sources for palliative care are similar between immigrants and those born in the US. Education is important and is a strong predictor of perceived knowledge of palliative care. Women perceive they have lower levels of knowledge of PC than men. Differences in end of life care between immigrants and non-immigrants cannot be explained by knowledge differences. Further research is needed to examine the potential factors including suboptimal communication between providers and immigrant patients to understand why these differences are noted. Future strategies for improving knowledge of palliative care should target health care providers as the key trusted source of information to help address deficits noted in this study.

Assessment of palliative care services in western Kenya.

The need for palliative care services is rapidly increasing due to the rising number of patients with non-communicable diseases. The objective of this study was to assess the current availability and barriers to palliative care and healthcare worker knowledge and perceptions on palliative pain control in western Kenya. An evidence-based 40-question assessment tool was conducted between October 2015 and February 2016 in Siaya County, western Kenya. All level 4 and 5 facilities (e.g., regional and district hospitals) were assessed, as well as a selection of lower-level facilities chosen via convenience sampling, stratified by facility level (e.g., dispensaries, health centers, and health clinics). A key informant at each of 22 facilities was surveyed and included 1 medical officer (5%), 12 clinical officers (55%), and 9 nurses (41%). Key themes included training and education, awareness of palliative care and hospice, services provided, and pain control. All 22 providers had heard of palliative care and 4 (18%) had received formal training. Fourteen (64%) providers knew that morphine was on the World Health Organization (WHO) essential medication list, 8 (36%) had previously prescribed opioids, and 5 (23%) had prescribed them for palliation. Provider concerns for opioid use included its addictive properties (59%), appropriate dosing (9%), cost (5%), side effects (9%), and availability (5%). Palliative care and hospice services were identified by providers as important components in the management of chronic illnesses in western Kenya. Further provider education as well as increased access to pain medications including opioids is necessary to improve the care of patients in western Kenya.