Palliative care in Mozambique: Physicians' knowledge, attitudes and practices

Autores da FMUP

• 

  Guilhermina Maria Da Silva Rêgo

  Autor

Participantes de fora da FMUP

• Pinto, E
• Marcos, G
• Walters, C
• Gonçalves, F
• Sacarlal, J
• Castro, M.

Unidades de investigação

• Medicina da Comunidade, Informação e Decisão em Saúde

• Recursos Comuns

  

  Investigador

  Guilhermina Maria Da Silva Rêgo

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background Palliative care is an essential part of medical practice but it remains limited, inaccessible, or even absent in low and middle income countries. Objectives To evaluate the general knowledge, attitudes, and practices of Mozambican physicians on palliative care. Methods A cross-sectional observational study was conducted between August 2018 and January 2019 in the 3 main hospitals of Mozambique, in addition to the only hospital with a standalone palliative care service. Data was collected from a self-administered survey directed to physicians in services with oncology patients. Results Two hundred and seven out of 306 physicians surveyed answered the questionnaire. The median physician age was 38 years. Fifty-five percent were males, and 49.8% residents. The most common medical specialty was surgery with 26.1%. Eighty percent of physicians answered that palliative care should be provided to patients when no curative treatments are available; 87% believed that early integration of palliative care can improve patients' quality of life; 73% regularly inform patients of a cancer diagnosis; 60% prefer to inform the diagnosis and prognosis to the family/caregivers. Fifty percent knew what a "do-not-resuscitate" order is, and 51% knew what palliative sedation is. Only 25% of the participants answered correctly all questions on palliative care general knowledge, and only 24% of the participants knew all answers about euthanasia. Conclusions Mozambican physicians in the main hospitals of Mozambique have cursory knowledge about palliative care. Paternalism and the family-centered model are the most prevalent. More interventions and training of professionals are needed to improve palliative care knowledge and practice in the country.

Keywords

• Adult; Aged; Attitude of Health Personnel; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Male; Middle Aged; Mozambique; Palliative Care; Surveys and Questionnaires; adult; article; attitude; cancer diagnosis; caregiver; controlled study; do not resuscitate order; euthanasia; human; male; Mozambique; multicenter study; observational study; palliative therapy; paternalism; prognosis; quality of life; questionnaire; resident; sedation; aged; attitude to health; cross-sectional study; female; health personnel attitude; middle aged; Mozambique; palliative therapy; psychology