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Doctor's Perception and Referral Barriers toward Palliative Care for Advanced Cancer Patients  

Lee, Jae-Ri (Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Jung-Kwon (Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Hwang, Sun-Jin (Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Ji-Eun (Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Chung, Ji-In (Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Si-Young (Division of Medical Oncology, Kyung Hee University School of Medicine)
Publication Information
Journal of Hospice and Palliative Care / v.15, no.1, 2012 , pp. 10-17 More about this Journal
Abstract
Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.
Keywords
Palliative care; Hospice care; Physicians; Perception; Referral and consultation;
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