EVALUATION OF THE UNDERGRADUATE MEDICAL STUDENTS ON THE AWARENESS OF PALLIATIVE CARE IN END-STAGE CANCER PATIENTS.

Background: Many countries have recognized palliative care as an imperative element of the medical system, the importance of which has been emphasized by the World Health Organization (WHO) and the World Health Assembly (WHA). An increase in the aging population, along with a rise in the number of individuals with critical illnesses such as cancer, dementia, diabetes, COPD, have increased the demand for palliative care. The inclusion of an effective palliative care teaching in medical and other allied medical science undergraduate curricula has become a requisite, which will enable tomorrow's health care practitioners to deliver the best possible end-of-life care to patients. This research aims to assess medical students' knowledge about palliative care in end-stage cancer patients.Objectives: Evaluation of the undergraduate medical students on the awareness of palliative care in end-stage cancer patients in Rawalpindi/Islamabad.Material and Methods: A descriptive, cross-sectional study was conducted in which 452 medical students (MBBS, BDS, BSN, and DPT), selected by convenience sampling, filled out the questionnaire which was made on the work of Çıtıl R, Okan İ, Önder Y, Çeltek NY, Süren M, Bulut YE, et al. (permission granted) comprising 21 questions, that were distributed via link to Google form. Certain student demographics were also collected. First and second-year medical students were excluded due to lack of exposure in the clinical setting. Chi-square test was performed to see if there is any significance between students studying in different medical courses and the relevant questions regarding end-stage cancer patients and palliative care. p<0.05 was considered to be statistically significant. Statistical data thus obtained was analyzed using SPSS version 23. Results: From a total of 452 medical students, 278 were females (61.5%) and 174 were males (38.5%). The ages ranged from 19 to 25 with 22 being the mean age with SD 0.962. 26.1% never heard of palliative care and 82.7% felt that the knowledge they have regarding palliative care is insufficient. 68.4% were apprehensive in communicating with a cancer patient. 35% of the students encountered an end-stage cancer patient and 62% felt that end-stage patients should be resuscitated, which were both found to be highly significant in terms of their medical profession (p<0.05). No significant difference was found among students who have interest in gaining palliative care education, if the knowledge they have is sufficient enough, if they are interested in offering end-of-life care, if they encountered a death case due to cancer, and if they felt nervous in communicating with such patients in terms of their professional medical course (p>0.05). 79% of undergraduates highlighted the importance of gaining education in palliative care and 66.6% would want to work in providing end-of-life care.Conclusion: Students of all medical courses lacked sufficient knowledge regarding palliative care. A large portion of them were hesitant to communicate with cancer patients. They wish to study and learn more about end-of-life care, and several indicated a desire to work in the palliative care discipline. Therefore, it is a necessity for future medical practitioners to get prompt knowledge about palliative care along with its practical implementation which calls for a revised medical curriculum for undergraduates.

Key words: Palliative care, Medical students, Awareness, Education