The Concept of Palliative Care Practice among Iranian General Practitioners

Introduction: General Practitioners (GPs) have the main responsibility in medical and particularly palliative care provision in most of countries, though this is not the current case in Iran. Development of 'family physician' approach in rural and most of the urban areas in Iran, GPs will have the main role in care provision. There is no formal palliative care education during general medical training in the country so far. Regarding the increasing number of people in need of palliative care services, it is essential to assess GPs' knowledge about palliative care to develop special palliative care educational programmes. Method: A cross-sectional questionnaire survey was conducted on general practitioners participated in a formal Continuous Medical Education programme, using three scales. Results: 216 GPs returned the completed questionnaires. More than half scored their knowledge about palliative care as weak, which was significantly related to their previous experience in caring of a terminally ill patient (p=0.001). Less than one third stated their good ability to either assess or manage pain in end of life. Major gender differences were seen in different subscales such as communication with patients and carers, patient management, palliative care knowledge and skills, and psychological stress. Conclusion: This study revealed a profound lack of knowledge and experience among Iranian general practitioners about palliative care which was mostly in more complicated areas rather than common symptoms relief.