Doctors’ knowledge, attitudes and practices of palliative care in two South African districts

Background: In South Africa, most palliative care takes place in health districts as part of home-based care provided by nongovernment organisations (NGOs). The National Policy Framework and Strategy on Palliative Care (NPFSPC) aims to ensure adequate numbers of palliative care trained healthcare workers. Guidelines and tools such as the Supportive and Palliative Care Indicators Tool (SPICT) assist in identifying and caring for patients needing palliative care. Aim: To evaluate the knowledge, attitudes and practices of public sector doctors to provide palliative care in the Garden Route and Central Karoo Districts. Setting: The study was conducted at public sector district-level hospitals. Methods: A descriptive observational cross-sectional survey was conducted. The study population included all public sector district-level doctors. Participation was voluntary, and 73 responses (60%) were obtained. Data were collected with an online questionnaire using the adapted ‘Knowledge Attitudes Practice’ model. Quantitative data were imported into the Statistical Package for Social Sciences for analysis. Results: Participants had poor knowledge, attitudes and practices regarding palliative care. There was a statistically significant difference between the knowledge of junior doctors and senior doctors, with 78% of junior doctors having inadequate palliative care knowledge. Only 25% of respondents had received formal postgraduate palliative care training. Seventy (96%) participants reported that home was the best care setting for terminally ill patients. Conclusion: Doctors in the Garden Route and Central Karoo need further training to meet the NPFSPC standards. Contribution: This study adds to the palliative care field, highlighting the need for ongoing training of doctors.