Palliative care in Mozambique: Physicians' knowledge, attitudes and practices

PLoS One. 2020 Aug 24;15(8):e0238023. doi: 10.1371/journal.pone.0238023. eCollection 2020.

Abstract

Background: Palliative care is an essential part of medical practice but it remains limited, inaccessible, or even absent in low and middle income countries.

Objectives: To evaluate the general knowledge, attitudes, and practices of Mozambican physicians on palliative care.

Methods: A cross-sectional observational study was conducted between August 2018 and January 2019 in the 3 main hospitals of Mozambique, in addition to the only hospital with a standalone palliative care service. Data was collected from a self-administered survey directed to physicians in services with oncology patients.

Results: Two hundred and seven out of 306 physicians surveyed answered the questionnaire. The median physician age was 38 years. Fifty-five percent were males, and 49.8% residents. The most common medical specialty was surgery with 26.1%. Eighty percent of physicians answered that palliative care should be provided to patients when no curative treatments are available; 87% believed that early integration of palliative care can improve patients' quality of life; 73% regularly inform patients of a cancer diagnosis; 60% prefer to inform the diagnosis and prognosis to the family/caregivers. Fifty percent knew what a "do-not-resuscitate" order is, and 51% knew what palliative sedation is. Only 25% of the participants answered correctly all questions on palliative care general knowledge, and only 24% of the participants knew all answers about euthanasia.

Conclusions: Mozambican physicians in the main hospitals of Mozambique have cursory knowledge about palliative care. Paternalism and the family-centered model are the most prevalent. More interventions and training of professionals are needed to improve palliative care knowledge and practice in the country.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Mozambique
  • Palliative Care / psychology*
  • Palliative Care / statistics & numerical data
  • Surveys and Questionnaires

Grants and funding

EP was supported by Calouste Gulbenkian Foundation grant number Nº.144879. Travel expenses for data collections in the 4 hospitals was supported by the Ministry of Health of Mozambique (MISAU).