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. reference: 1.asadi-lari m, sayyari aa, akbari me, gray d. public health improvement in iran--lessons from the last 20 years. public health. 2004 sep;118(6):395-402. 2.webster r, lacey j, quine s. palliative care: a public health priority in developing countries. j public health policy. 2007;28(1):28-39. 3.pisani p, parkin dm, bray f, ferlay j. estimates of the worldwide mortality from 25 cancers in 1990. int j cancer. 1999 sep 24;83(1):18-29. 4.unaids. 2006 report on the global aids epidemic: executive summary. geneva: unaids; 2006 contract no.: document number|. 5.morris k. cancer? in africa? lancet oncol. 2003 jan;4(1):5. 6.higginson ij, astin p, dolan s. where do cancer patients die? ten-year trends in the place of death of cancer patients in england. palliat med. 1998 sep;12(5):353-63. 7.petchy r, carter y, williams j, asadi-lari m, curtis se, fagg j, et al. ‘living with cancer’; national evaluation of big lottery fund cancer services in the uk. final report to big lottery fund. london: big lottery fund; 2006 contract no.: document number|. 8. meijler wj, van heest f, otter r, sleijfer dt. educational needs of general practitioners in palliative care: outcome of a focus group study. j cancer educ. 2005 spring;20(1):28-33. 9.mitchell gk. how well do general practitioners deliver palliative care? a systematic review. palliat med. 2002 nov;16(6):457-64. 10.barrington dl, murrie da. a preceptor model for introducing undergraduate medical students to palliative medicine. j palliat care. 1999 spring;15(1):39-43. 11.mason s, ellershaw j. assessing undergraduate palliative care education: validity and reliability of two scales examining perceived efficacy and outcome expectancies in palliative care. med educ. 2004 oct;38(10):1103-10. 12. azevedo sao leao ferreira k, kimura m, jacobsen teixeira m. the who analgesic ladder for cancer pain control, twenty years of use. how much pain relief does one get from using it? support care cancer. 2006 nov;14(11):1086-93. 13.asadi-lari m, madjd z, akbari me. the need for palliative care services in iran; an introductory commentary. iranian journal of cancer prevention. 2008;1(1):1-5. 14.dumitrescu l, van den heuvel wj, van den heuvel-olaroiu m. experiences, knowledge, and opinions on palliative care among romanian general practitioners. croat med j. 2006 feb;47(1):142-7.