Public Knowledge and Attitudes Concerning Palliative Care

Background: WHO recommends early integration of palliative care alongside usual care to improve quality of life; misunderstanding of palliative care may impede this. We aimed to compare the public’s perceived and actual knowledge of palliative care, and examine associations of this knowledge with attitudes concerning palliative care.   Methods: We analyzed data from an online cross-sectional survey of a representative sample of the Canadian public, accessed through a survey panel in May-June, 2019. We compared high perceived knowledge (“know what palliative care is and could explain it”) with actual knowledge of the WHO definition (knew at least 5/8 components including that palliative care can be provided early in the illness and together with life-prolonging treatments), and examined their associations with attitudes to palliative care. Findings: Of 1518 eligible participants, 45% had high perceived knowledge, of whom 46% had high actual knowledge. Participants with high (vs. low) perceived knowledge were more likely to associate palliative care with end-of-life care (adjusted odds ratio, 2.15[95%CI, 1.66-2.79]) and less likely to believe it offered hope (0.62[0.47-0.81] ). Conversely, participants with high (vs. low) actual knowledge were less likely to associate palliative care with end-of-life care ( 0.59[0.46-0.76] ) , less likely to find palliative care fearful or depressing, and more likely to believe it offer ed hope (1.88[1.46-2.43]).    Interpretation: Stigma regarding palliative care may be perpetuated by those who falsely believe they understand its meaning. Public health education is needed to increase knowledge about palliative care, promote its early integration, and counter false assumptions Funding Statement: This research was funded by the Canadian Institutes of Health Research (grant number 152996; CZ) and the Ontario Ministry of Health and Long-Term Care. Dr. Zimmermann is supported by the Rose Family Chair in Palliative Medicine and Supportive Care, Department of Medicine, University of Toronto. Declaration of Interests: The authors declare that there is no conflict of interest. Ethics Approval Statement: The study was approved by the University Health Network Research Ethics Board (#18-6039).