Cross-Cultural Comparison on Palliative Care Knowledge in Community and University Samples in the Tropics

Towards a Public Health Approach to Palliative Care

Our Team

• Associate Professor Wendy Li (Team Leader, JCU)
• Dr Smita Singh (JCU Singapore)
• Dr Jasleen Chhabra (Project Manager, MD, PhD candidate, JCU)
• Quan Zhou (Palliative care nurse, Townsville Hospital).

The Project

AMHRG members, A/Prof Wendy Li, Dr Smita Singh, Dr Jasleen Chhabra and Quan Zhou, have been awarded a grant from the JCU College of Healthcare Sciences JCUA and JCUS Cross-collaboration scheme to conduct a cross-cultural study on palliative care knowledge. The project aims to investigate palliative care (PC) knowledge in community and university samples in Australia and Singapore and provide empirical evidence to palliative care education for the tropical communities.

According to WHO (2019), PC is an approach that improves the quality of life of patients with life-threatening illness and their families, through the prevention and relief of suffering by means of early identification, impeccable assessment and treatment of pain and related physical, psychosocial and spiritual issues. WHO pioneered a public health approach to integrating PC into a country’s healthcare system (Stjernsward, Foley & Ferris, 2007). Public health approach to PC involves community education, which will improve social responses to, enhance support in, and address anxiety about, death, dying, loss and end of life care for families and communities (Public Health Palliative Care International, 2019). In the past decades, palliative services have prioritised community engagement by embracing the public health approach. The initiatives include health promotion, community development and death education into PC that was previously focused primarily on clinical care (Kellehear, 2013). These initiatives provide the possibility of solving the inequity of the difference in the provision of care for those people with life-limiting illnesses. (Abel, 2018).

Despite the fact that PC enhances the quality of life for patients with life-limiting illness and their families, palliative care remains underutilised (Kozlov, McDarby, Reid, & Carpenter, 2018). Research has identified barriers to accessing PC services, including patient and family reluctance, fear, misconception, ignorance and lack of awareness of resources. Grossman and Kaestner (1997) posited that knowledge of a health service improves the utilisation of service because consumers better understand the benefits of the service. Kozlov and associates (2018) identified that knowledge of PC is positively correlated to improved utilisation of PC services. Thus, increasing the knowledge and overall awareness of PC in the public is crucial for PC education (Huo et al., 2019, Chan 2008).

Since the 1980s, PC has been established as a specialised area in the Australian healthcare system (Cairns, 2007). The Singapore Hospice Council was established in 1995, acting as an umbrella body representing all organisations that actively provide PC in Singapore (The Singapore Hospice Council, 2019). Both countries are committed to providing high quality PC services. However, there is a lack of research related to PC awareness in both countries. The proposed study aims to address the research gap. To our knowledge, this is the first cross-cultural study in PC knowledge. With ageing population on the rise in both countries, research into PC awareness and knowledge is more important now than ever.

To achieve the research aim, a systematic analysis of PC awareness education will be conducted. A cross-sectional design will also be employed using online survey in community and university samples of 200 participants each in Australia and Singapore. Measurements include: 1) Demographics: Age, gender, ethnicity, education level, marital status, and annual income; 2) The 13-item Palliative Care Knowledge Scale (Kozlov et al., 2018); 3) The 4-item Experience with Palliative Care Questionnaire (Kozlov, 2016).