Palliative care is fundamental to health and a basic human right. Healthcare professional are often the gatekeeper to palliative care for their patients, but there is great disparity in access to palliative care across Malaysia, and little knowledge about healthcare professionals’ perception towards palliative care at the end of life in Sarawak.
We surveyed all healthcare professionals who attended a palliative care seminar and talk by Prof Dr Anne Merriman, founder and director of policy and International program, Hospice Africa when she visited Kuching, Sarawak on 5th and 6th April 2018. Participants were asked to answer a questionnaire designed by Prof Merriman which comprises of 25 questions in trochotomous scale.
A total of 186 responses were obtained, of which 68% (127) were doctors and 25% (46) were nurses. 80% (149) responded that they would like to die at home, while only 5% (9) preferred to pass away in hospital. 96% (179) wished to have family with them and 84% (157) wanted spiritual guidance at the end of life. Only 41% (76) reported that they were afraid to die, yet majority responded that they were afraid of a painful death (86%;160), a prolonged dying process (89%; 164) and troubling others (90%; 167). Less than 50% of healthcare professional surveyed felt that they were able to help patients achieved adequate pain control (43%;80) or support patients emotionally (42%;78), and majority (58%) reported lack of knowledge being the barrier. 95% (176) reported that they would like to attend more palliative care seminars and 92% (171) would like to have palliative care in their unit. 26% (48) responded that they would like it to be lawful to practice euthanasia, but only 15% (28) were prepared to actively practice euthanasia if it is legal.
Home is the preferred place of death even amongst healthcare professional in Sarawak. Lack of knowledge and professional training remains a major barrier to access of palliative care. The survey highlighted the need for palliative care training for local healthcare professional as well the need to develop hospice home care services in our State to provide better palliative care and end of life care for patients and families. Advocacy for advanced directives should be initiated.
Clinical trial identification
Legal entity responsible for the study
Winnie Hui Yee Ling.
Has not received any funding.
All authors have declared no conflicts of interest.