Background Globally, the public health approach to palliative care has gained momentum embedded within policy and practice. Despite the documented benefits of palliative care and advance care planning, multiple factors limit utilisation of these services, including lack of knowledge and misconceptions.
Aim: To assess awareness, knowledge, and attitudes about palliative care and advanced care planning among the public.
Methods: a Mixed methods study comprising two phases. Phase 1: A cross-sectional study analysing data collected as part of the annual Northern Ireland Life and Times (NILT) survey with a randomised sample of adults. The Palliative Care Knowledge Scale, a validated instrument, comprising thirteen items was used to assess palliative care and advance care planning items were developed informed from a review of policy and literature. Phase 2: comprised 20 in-depth exploratory interviews and two focus groups (n=5) with a purposive sample of adults (n=25). Data were analysed using NVivo 10 software, based on thematic analysis.
Results: Of the 1,201 participants, 86% reported being familiar with the term palliative care, but this was perceived to be for older people, delivered at the end of life in the acute care setting. Analysis revealed age, gender, education and geographic location were statistically significant on scoring patterns. Higher education was found to increase the likelihood of having heard of advanced care planning. Whilst 81% supported the use of advance care plans, over half were not interested in engaging with the behaviour. qualitative data revealed that participants supported the concept of ACP, however confusion regarding the terminology, utilisation and application existed. Beliefs that prior exposure to illness was the key prompt to engaging and developing such plans, led to misconceptions regarding their focus and who was involved in their development.
Discussion: Public health initiatives are needed to increase awareness of and reduce misconceptions of palliative care, advance care planning and services. Concerted efforts are needed to embed a public health approach in palliative care and advance care planning