Knowledge, beliefs, and misconceptions about palliative care among older adults with cancer

The utility and feasibility of incorporating death cafes in undergraduate education: A qualitative exploration of medical and nursing students' perspectives

BACKGROUND

The current medical and nursing curricula place little emphasis on palliative and end-of-life care. Consequently, students are less comfortable in communicating about topics related to death and dying when providing palliative and end-of-life care. Death cafés utilizes a facilitator-led small group to encourage conversations about death and dying to take place alongside food and beverages in a safe environment. In light of the presence of death taboos, there is a need to understand how medical and nursing students perceive the incorporation of a death café within the undergraduate program.

OBJECTIVES

This study aimed to explore the perceptions of medical and nursing students regarding the utility and feasibility of incorporating death cafés into their undergraduate education.

DESIGN

A qualitative study was conducted.

METHODS

This study was conducted in one medical school in a university in Singapore. Participants above the ages of 18 years, pursuing a full time undergraduate medical or nursing program were invited. A purposive sampling approach using the maximum variation sampling technique to enhance representativeness was used to select the participants based on their sociodemographic and academic variables. A total of 32 medical and nursing students were included in the study. Online individual interviews were conducted. The interviews were then transcribed and analyzed using qualitative content analysis.

RESULTS

Three main categories were developed from the content analysis: (1) Perceptions of death cafés, (2) Features of a death café, and (3) Contents of a death café conversation. Participants viewed the death café as a platform for conversations surrounding death and dying. Several features such as the presence of a facilitator and discussions to be held in small groups were surfaced. The proposed topics to be discussed ranged from communication skills, coping with death encounters, and understanding more about the concepts of palliative care.

CONCLUSION

Medical and nursing students view death cafes as a feasible and potential approach in learning pallative and end-of-life care. The use of a faciliator-guided small group discussion on topics such as coping with death, communication techniques and concepts of palliative care are proposed. Further work is needed to examine how the death café method can potentially impact students' confidence and skills in managing palliative and end-of-life care.

What Does "Palliative" Mean? Sentiment, Knowledge, and Public Perception Concerning Palliative Care on the Internet since the COVID-19 Pandemic

Background

Little is known about the public perception of palliative care during and after the pandemic. Assuming that analyzing online language data has the potential to collect real-time public opinions, an analysis of large online datasets can be beneficial to guide future policymaking.

Objectives

To identify long-term effects of the COVID-19 pandemic on the public perception of palliative care and palliative care-related misconceptions on the Internet (worldwide) through natural language processing (NLP).

Design

Using large language model NLP analysis, we identified public attitudes, opinions, sentiment, and misconceptions about palliative care on the Internet, comparing a corpus of English-language web texts and X-posts ("tweets") (02/2020-02/2022) with similar samples before (02/2018-02/2020) and after the pandemic (03/2022-02/2024).

Setting

The study is a statistical analysis of website and social media data, conducted on six large language corpora.

Results

Since the COVID-19 pandemic, palliative care situations are more often portrayed as frightening, uncertain, and stressful, misconceptions about the activities and aims of palliative care occur on average 44% more frequently, especially on the social media platform X.

Conclusions

The impact of the COVID-19 pandemic on public discussion on social media continues to persist even in 2024. Insights from online NLP analysis helped to determine the image of palliative care in the Internet discourse and can help find ways to react to certain trends such as the spread of negative attitudes and misconceptions.

Piloting a Patient Tool to Aid Palliative Care Referrals during Advanced Lung Cancer Treatment

CONTEXT

Patient misperceptions are a strong barrier to early palliative care discussions and referrals during advanced lung cancer treatment.

OBJECTIVES

We developed and tested the acceptability of a web-based patient-facing palliative care education and screening tool intended for use in a planned multilevel intervention (i.e., patient, clinician, system-level targets).

METHODS

We elicited feedback from advanced lung cancer patients (n = 6), oncology and palliative care clinicians (n = 4), and a clinic administrator (n = 1) on the perceived relevance of the intervention. We then tested the prototype of a patient-facing tool for patient acceptability and preliminary effects on patient palliative care knowledge and motivation.

RESULTS

Partners agreed that the intervention-clinician palliative care education and an electronic health record-integrated patient tool-is relevant and their feedback informed development of the patient prototype. Advanced stage lung cancer patients (n = 20; age 60 ± 9.8; 40% male; 70% with a technical degree or less) reviewed and rated the prototype on a five-point scale for acceptability (4.48 ± 0.55), appropriateness (4.37 ± 0.62), and feasibility (4.43 ± 0.59). After using the prototype, 75% were interested in using palliative care and 80% were more motivated to talk to their oncologist about it. Of patients who had or were at risk of having misperceptions about palliative care (e.g., conflating it with hospice), 100% no longer held the misperceptions after using the prototype.

CONCLUSION

The palliative care education and screening tool is acceptable to patients and may address misperceptions and motivate palliative care discussions during treatment.

Knowledge, feelings, and willingness to use palliative care in cancer patients with hematologic malignancies and solid tumors: a prospective, cross-sectional study in a comprehensive cancer center in Germany

PURPOSE

Patients with hematologic malignancies (HM) receive palliative care (PC) less often and later than patients with solid tumors (ST). Patients' lack of knowledge about PC and negative feelings about PC are barriers to their willingness to use PC. Is there a difference between patients with HM and ST in their knowledge and willingness to use PC?

METHODS

Two hundred ten patients (85 HM, 125 ST) from an oncology day clinic at a university hospital participated in this cross-sectional, questionnaire-based survey.

RESULTS

Patients with HM and ST had high knowledge and mainly positive feelings about PC. More than half of the patients answered that they would feel reassured by the use of PC, and one-third would feel anxious or hopeless. The majority of patients (58.3%) were willing to use PC. There are no significant differences between patients with HM and ST. In multiple regression analysis, perceived chance of cure and feelings of reassurance and anxiety are associated with willingness to use PC, but not with the HM/ST disease group. More than half (53.9%) of the participants would like the treating physician to choose the timing of a discussion about PC.

CONCLUSION

Our study shows a high level of knowledge and relatively positive feelings of patients about PC, with no differences between patients with HM or ST. They expect their treating physician to initiate communication about PC. Communication should include the patient's feelings about PC and their chances of a cure.