We investigated the awareness of palliative care (PC) services in advanced cancer patients and their family caregivers and whether negative perceptions was a possible barrier to PC utilisation in Singapore. Materials and Methods: Patients with stage 4 solid cancer and their caregivers were interviewed between July 2016 and March 2018 at outpatient clinics located in the medical oncology departments of 2 major public hospitals in Singapore. Patients and caregivers were asked whether they were aware of PC services, how they first learned about them, who first recommended PC to the patient, whether the patient had received PC, and reasons for not receiving PC. Results: Awareness of PC was lower in patients compared to caregivers (43% vs 53%; P <0.01). The odds of being aware in patients was higher if they had higher education (odds ratio [OR] = 2.927; P <0.001) and higher income (OR = 1.798; P = 0.005). Compared to patients, more caregivers reported that a healthcare provider recommended PC to the patient (10% vs 20%; P <0.012). Furthermore, 7% of patients and 15% of caregivers reported that the patient received PC (P = 0.031). The most common reasons for not receiving PC reported by patients and caregivers (respectively) were that the patient was still receiving treatment (68% and 78%), it is not time for PC (76% and 59%) and PC would not be of help (18% and 19%). Conclusion: Less than half of patients indicated an awareness of PC. Our findings suggest that efforts should be made to increase awareness of PC and promote its acceptance in cancer patients and their family caregivers in Singapore.
Cancer is the primary cause of death in Singapore and accounts for 30% of all deaths.1 Patients with advanced cancer suffer from many problems including pain, side effects from treatment and psychological distress.2,3 To respond to the needs of these patients, international and local organisations recommend that palliative care (PC) be provided early in the course of illness and integrated with standard oncology care.4,5 The goal of PC is to improve the quality of life of patients with any life-limiting illness and of their family caregivers by addressing physical, psychosocial and spiritual needs.4 Several studies have shown that patients with advanced cancer who receive early integration of PC have better quality of life and less depression compared to patients who receive standard oncology care.
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