Perception, Knowledge and Barriers to End of Life Palliative Care among Neonatal and Pediatric Intensive Care Physicians

Abstract

Objective: To determine perception, knowledge, and barriers to the end of life palliative care among neonatal and pediatric intensive care physicians mainly practicing in Kuwait. Methods: This study focuses a detailed self-administered questionnaire based measurements. One hundred and ninety-two (192) Kuwait based neonatal and pediatric intensive care physicians actively evaluated the survey conducted in this study. All the inquiries during this investigation were formatted using a 5-point Likert scale. However, responses to few questions are recorded in a yes or no format as 5-point Likert scale was not applicable to those issues. Results: The response rate was in a range of 80-85% with 157 respondents completing the survey. Of the total 157, 65% (102) were neonatologists and 35% (55) were pediatric intensivists. Thirty-two (21%) were consultant staff, and almost half (n=76, 48%) have more than ten years’ experience. Only 20% had prior training in end of life palliative care, and 19% have a current guideline. Also, only 12% have access to palliative care consultation team. Four different factors from both family support and team were perceived to support the provision of palliative care of a high quality. While the involvement of multidisciplinary team, pain management and formal teaching of EOL palliative care were the major components of team factors; the family support also engaged the involvement of parents/family in EOL palliative care decision. Cultural and religious constraints, lack of palliative care team and insufficient knowledge formed as major barriers. Conclusion: In this study, neonatologists and pediatric intensivists reiterate the importance of palliative care. They evaluated both the facilitators (perception and knowledge) and barriers (cultural and religious constraints, lack of palliative care team and insufficient expertise) that significantly impact the quality of neonates and pediatrics palliative care.