ArticleBMJ open2025
Assessment of palliative care knowledge among hospital physicians and nurses in conflict-affected, resource-limited settings: a multicentre cross-sectional study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesMost people who require palliative care reside in low- and middle-income countries, particularly those living in areas affected by geopolitical conflict such as Palestine. Given the potential impact of conflicts on the palliative care knowledge of healthcare providers, it is crucial to assess how it is affected by the recent political instability occurring in the area. This study aimed to assess the overall and domain-specific palliative knowledge among physicians and nurses and evaluate the factors associated with palliative care knowledge.
designCross-sectional multicentre study.
settingThe study sample was recruited from eight hospitals in two districts in the West Bank, Palestine.
participantsPhysicians and nurses working in the following hospital departments were eligible for inclusion in the study: internal medicine/cardiology/nephrology, surgical department, intensive care unit/emergency department and oncology department. Among 227 physicians and nurses approached, 197 participated (response rate 87%), and all of them completed the study. OUTCOME MEASURES: The palliative care knowledge test was used to assess the palliative care knowledge of study participants. Bivariate analysis and multiple binary logistic regression were used to evaluate associations with palliative care knowledge. A p value of less than 0.05 was considered statistically significant.
resultsThere was no significant difference between physicians and nurses in overall palliative care knowledge. Study participants scored poorly in all palliative care knowledge domains. However, physicians scored significantly higher in the 'philosophy' domain (p 0.035), while nurses scored significantly higher in the 'psychiatric' domain (p 0.009). Questions with the lowest rate of right answers were related to opioids and dyspnoea. Previous training in palliative care was significantly associated with palliative care knowledge (OR 2.529, 95% CI 1.267 to 5.049, p 0.009).
conclusionsPhysicians and nurses in conflict-affected, resource-limited settings had insufficient knowledge in all palliative care domains. The lowest knowledge scores were for the 'dyspnoea' and 'opioid' questions. Participants with previous training in palliative care had significantly more palliative care knowledge. National guidelines and comprehensive palliative care training programmes should be developed to facilitate palliative care delivery.
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