Knowledge and Adherence to Palliative Care Practices

Knowledge and Adherence to Palliative Care Practices | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Knowledge and Adherence to Palliative Care Practices Jane Christine Rodrigues Magalhães¹, Gisele Mara Silva Gonçalves¹ This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9394500/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 12 You are reading this latest preprint version Abstract Healthcare professionals’ perceptions of palliative care (PC) vary and are shaped by culture, training, and access to resources. This study aimed to identify perceptions and knowledge gaps regarding PC among healthcare professionals in a Brazilian hospital, aligned with the National Humanization Policy of the Unified Health System (SUS). An observational, quantitative study used a questionnaire administered to physicians, nurses, social workers, physical therapists, nutritionists, psychologists, nursing technicians, and other professionals. About one quarter of participants were unaware of the hospital’s care services, with significant differences across professions (p < 0.001). Key barriers included prognostic uncertainty, limited conceptual understanding of PC, and concerns about patient and family acceptance, consistent with international reports. Participants agreed that broader professional involvement in end-of-life discussions is needed and that PC services were underused (p = 0.003), mainly because of limited access to or adherence to information. Professional training influenced decisions about PC, and confusion persisted regarding the appropriate timing of initiation. Targeted awareness, interprofessional education, and better information flow are required to strengthen implementation and timely access to PC in routine practice across clinical services. Palliative Care Health Personnel Perception Tertiary Care Centers Surveys and Questionnaires Introduction In the face of the complex and challenging nature of life-threatening illnesses, whether acute or chronic and regardless of the possibility of reversal or curative treatment, healthcare professionals are tasked with providing a comprehensive and complex approach that prioritizes the overall well-being of the patient while also considering the suffering of their family. It is a significant challenge for both public and private healthcare sectors in Brazil and globally [ 1 ]. As professionals navigate this intricate landscape, palliative care (PC) emerges as an increasingly prevalent and indispensable approach in their practice. The perception of PC among healthcare professionals varies and is influenced by various factors, including cultural context, professional training, and access to resources. Globally, understanding and acceptance of PC have evolved, but significant challenges remain [ 2 – 3 ]. Studies, such as that of Burt et al. [ 4 ], highlight that some healthcare professionals may encounter barriers to addressing PC, such as a lack of specific training or concerns about sensitive communication with patients and their families regarding end-of-life issues. In the Brazilian context, these challenges are compounded by unique cultural and organizational barriers that shape the perception and delivery of PC. According to Magalhães et al. (2024), cultural misconceptions, such as the association of PC with giving up on curative treatment, hinder its broader acceptance. Organizational factors, including inadequate institutional support and fragmented care systems, further complicate the integration of PC into routine healthcare practice. These barriers not only limit the effectiveness of PC but also exacerbate disparities in access to and quality of care for patients facing life-threatening illnesses. Well-trained healthcare professionals tend to have a more holistic understanding of PC, recognizing its importance not only in pain management but also in emotional support, open communication, and promotion of patient dignity during the end-of-life phase. Furthermore, ongoing education and development of specific skills in PC are essential to improve the delivery of these services. A crucial challenge faced by healthcare professionals worldwide is the need for an integrated and coordinated approach among different medical specialties, nursing, social work, and other professionals to offer effective PC [ 5 ]. The perception of PC among healthcare professionals is constantly evolving, reflecting changes in health policies, advances in medical education, and public awareness of the importance of these services. According to the Brazilian ANCP (National Academy of PC), a considerable lack of awareness and prejudice related to PC still exists in Brazil, particularly among physicians, healthcare professionals, and hospital managers. PC is still often confused with euthanasia, and there is significant prejudice regarding the use of opioids such as morphine for pain relief [ 6 – 7 ]. Discomfort among professionals, physician resistance, and insufficient knowledge among the team regarding advanced care planning in patients with PC were identified [ 8 ]. Given this scenario, the present study becomes relevant because, upon analyzing the results, it is possible to either refute or corroborate the assertion above regarding the participating professionals. This is particularly relevant, considering that the research was conducted in a teaching hospital that serves as a professional training center. The primary objective of this study was to evaluate and compare the perceptions of healthcare professionals from various areas who care for patients requiring palliative care at a university hospital in Campinas, São Paulo, Brazil. The specific objectives included analyzing the academic background of the study population and assessing whether there is a correlation between understanding and adherence to the palliative care approach, as well as identifying areas for improvement in perception, knowledge, and adherence in the care provided to individuals in the context of palliative care. The initial hypothesis was that professionals' knowledge of palliative care was insufficient and could vary according to profession. Methods Study Design An observational study that used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) instrument to guide the methodology. Sampling strategy The total number of potential participants was 1,474 individuals, including 828 nursing technicians, 375 physicians, 207 nurses, 38 physiotherapists, 11 social workers, nine nutritionists, four psychologists, and two occupational therapists, among others. A total of 136 individuals responded to the questionnaire, and after applying inclusion and exclusion criteria, the sample consisted of 134 participants. Participants were grouped into three categories for comparison: physicians (n = 38), nurses (n = 54), and other multidisciplinary team members, including social workers, physiotherapists, nutritionists, psychologists, occupational therapists, and others (n = 42). Inclusion and exclusion criteria The study participants were hospital employees from various healthcare areas who agreed to participate by signing an informed consent form. The following were excluded: university students and professionals from other hospital sectors who were not directly involved in patient care. Data collection Data collection was performed using an online questionnaire based on the instrument used by Tay et al. [ 9 ]. There were 38 multiple-choice questions (demographic data collection and questions assessing PC perception). Responses were tabulated using categorical scales appropriate for statistical analysis. The questionnaire was formulated on a five-point Likert scale. Data collection took place in the last quarter of 2022. Analysis of results The profiles of the participants, their knowledge and perceptions of CP in the three groups, and their self-reported behaviors related to CP were analyzed comparatively. A comparison of perceptions between senior and junior participants was also performed. Statistical analysis was performed using R® software. An exploratory data analysis was conducted, employing summary measures (mean, standard deviation, median, first quartile, third quartile, frequency, and percentage). The association between categorical variables was evaluated using the Chi-square test. In contrast, comparisons between groups regarding numerical variables were performed using the Kruskal-Wallis or Mann-Whitney test, as appropriate. For all analyses, a significance level of 5% was considered. Sample power was analyzed based on two questions selected for relevance: "How much do you think critically ill patients will benefit from PC?" and "When would you consider a referral to PC?" The percentages obtained were 81.4% and 98.6%, respectively, indicating that the sample is sufficient for comparing professional groups. Results In summary, the median age of the participants was 34 years, with women comprising 87% of the group (Table 1 ). Most identified themselves as Catholic or Evangelical, with less than 5 years of professional training. In addition, many reported interactions with terminally ill patients, even without specific training in palliative care. The multidisciplinary team is younger than the teams of physicians and nurses (p-value < 0.001), with less professional experience (p-value = 0.004). The hospital's palliative care service is better known among physicians than among nurses (p-value < 0.001). Regarding religion, there were more Catholic physicians and more evangelical nurses (p-value = 0.002), more female physicians (p-value < 0.001), and fewer nurses with any training in palliative care (p-value = 0.021). Most participants consider palliative care to be extremely important in the treatment and management of patients in the final stages of life (Table 2 ). Similarly, most believe that frail elderly patients, cancer patients, patients with organ failure, and neurological patients with severe sequelae will benefit significantly from this approach. There were differences in the response to the question "When would you consider a referral to palliative care?" (p-value < 0.001). While physicians and multidisciplinary teams tend to consider this referral when the patient is first diagnosed with a life-limiting illness, nurses, on the other hand, generally choose to refer when the disease is already in its terminal stage (Table 3 ). Differences were also found among professionals in "How do you first communicate the option of palliative care to patients and family members?" (p-value = 0.001). Physicians are more likely to hold a meeting with the patient and/or family, while multidisciplinary teams tend to refer directly to palliative care. Nurses, on the other hand, are divided between holding a meeting with the patient and/or family, referring to palliative care, and not addressing the issue at all (Table 4 ). Regarding "Palliative care referrals are an underutilized service" (Table 5 ), nurses agree less with this statement than physicians and multidisciplinary teams (p-value = 0.003). Table 1 Participant profile regarding demographic data and PC knowledge by profession. Age 1 Total (n = 134) Physician (n = 38) Nurse (n = 54) Multi-team (n = 42) p-value 34.0 [26.0;42.0] 39.0 [29.0;48.5] 37.0 [27.0;42.0] 26.0 [24.0;33.0] < 0.001 Sex < 0.001 Female 116 (86.6%) 24 (63.2%) 52 (96.3%) 40 (95.2%) Male 18 (13.4%) 14 (36.8%) 2 (3.70%) 2 (4.76%) Religion 2 0.002 Catholic 65 (48.9%) 25 (67.6%) 20 (37.0%) 20 (47.6%) Spiritist 14 (10.5%) 3 (8.11%) 7 (13.0%) 4 (9.52%) Evangelical 37 (27.8%) 2 (5.41%) 23 (42.6%) 12 (28.6%) Other 17 (12.8%) 7 (18.9%) 4 (7.41%) 6 (14.3%) Professional Experience 0.004 20 years 21 (15.7%) 11 (28.9%) 5 (9.26%) 5 (11.9%) Do you have any training in PC? 0.021 No 100 (74.6%) 24 (63.2%) 47 (87.0%) 29 (69.0%) Yes 34 (25.4%) 14 (36.8%) 7 (13.0%) 13 (31.0%) Where did you learn about PC? a) Undergraduate: 0.183 No 64 (47.8%) 16 (42.1%) 31 (57.4%) 17 (40.5%) Yes 70 (52.2%) 22 (57.9%) 23 (42.6%) 25 (59.5%) b) Work: 0.927 No 27 (20.1%) 8 (21.1%) 10 (18.5%) 9 (21.4%) Yes 107 (79.9%) 30 (78.9%) 44 (81.5%) 33 (78.6%) c) Courses: 0.667 No 75 (56.0%) 19 (50.0%) 32 (59.3%) 24 (57.1%) Yes 59 (44.0%) 19 (50.0%) 22 (40.7%) 18 (42.9%) d) Communication: 0.301 No 97 (72.4%) 26 (68.4%) 43 (79.6%) 28 (66.7%) Yes 37 (27.6%) 12 (31.6%) 11 (20.4%) 14 (33.3%) e) Family: 0.530 No 115 (85.8%) 33 (86.8%) 48 (88.9%) 34 (81.0%) Yes 19 (14.2%) 5 (13.2%) 6 (11.1%) 8 (19.0%) How often do you interact with terminally ill patients? 0.099 Rarely 18 (13.4%) 4 (10.5%) 11 (20.4%) 3 (7.14%) Occasionally 27 (20.1%) 3 (7.89%) 12 (22.2%) 12 (28.6%) Frequently 40 (29.9%) 12 (31.6%) 15 (27.8%) 13 (31.0%) Very frequently 49 (36.6%) 19 (50.0%) 16 (29.6%) 14 (33.3%) Are you familiar with the PC service at this hospital? < 0.001 No 35 (26.1%) 2 (5.26%) 27 (50.0%) 6 (14.3%) Yes 99 (73.9%) 36 (94.7%) 27 (50.0%) 36 (85.7%) 1 Expressed as median [first quartile; third quartile]. Age: Kruskal-Wallis test. Other tests: Chi-square. Table 2 Participants' perceptions of PC by profession. What is the importance of the role of PC in the treatment/management of terminal patients? Total (n = 134) Physician (n = 38) Nurse (n = 54) Multi-team (n = 42) p-value 0.325 Important 5 (3.73%) 2 (5.26%) 3 (5.56%) 0 (0.00%) Other 129 (96.3%) 36 (94.7%) 51 (94.4%) 42 (100%) How much do you think frail elderly patients will benefit from PC? 0.378 Very beneficial 114 (85.7%) 34 (91.9%) 44 (81.5%) 36 (85.7%) Other 19 (14.3%) 3 (8.11%) 10 (18.5%) 6 (14.3%) How much do you think patients with dementia/Parkinson's disease will benefit from PC? 0.067 Very beneficial 105 (78.9%) 34 (91.9%) 39 (72.2%) 32 (76.2%) Other 28 (21.1%) 3 (8.11%) 15 (27.8%) 10 (23.8%) How much do you think cancer patients will benefit from PC? 0.752 Very beneficial 124 (93.2%) 35 (94.6%) 51 (94.4%) 38 (90.5%) Other 9 (6.77%) 2 (5.41%) 3 (5.56%) 4 (9.52%) How much do you think Patients with organ failure will benefit from PC? 0.735 Very beneficial 114 (85.7%) 33 (89.2%) 45 (83.3%) 36 (85.7%) Other 19 (14.3%) 4 (10.8%) 9 (16.7%) 6 (14.3%) How much do you think patients with severe neurological sequelae will benefit from PC? 0.275 Very beneficial 117 (88.0%) 35 (94.6%) 45 (83.3%) 37 (88.1%) Other 16 (12.0%) 2 (5.41%) 9 (16.7%) 5 (11.9%) How much do you think critically ill patients will benefit from PC? 0.017 Very beneficial 107 (80.5%) 35 (94.6%) 38 (70.4%) 34 (81.0%) Other 26 (19.5%) 2 (5.41%) 16 (29.6%) 8 (19.0%) Chi-square Test. Other: grouping of categories that presented a low number of responses for statistical analysis feasibility (4 beneficial + 3 somewhat beneficial; 2 not so beneficial + 1 not beneficial) or (4 important + 3 somewhat important; 2 not so important + 1 not important)." Table 3 Self-reported behaviors regarding PC by profession. When would you consider a referral to PC? Total (n = 134) Physician (n = 38) Nurse (n = 54) Multi-team (n = 42) p-value < 0.001 At the onset of symptoms 13 (9.70%) 4 (10.5%) 4 (7.41%) 5 (11.9%) When the disease becomes terminal 49 (36.6%) 10 (26.3%) 31 (57.4%) 8 (19.0%) When first diagnosed with a life-limiting illness 67 (50.0%) 22 (57.9%) 16 (29.6%) 29 (69.0%) If the family or patient demonstrates distress 5 (3.73%) 2 (5.26%) 3 (5.56%) 0 (0.00%) How confident are you in explaining the role of PC to patients? 0.584 Confident 102 (76.1%) 31 (81.6%) 39 (72.2%) 32 (76.2%) Not confident 32 (23.9%) 7 (18.4%) 15 (27.8%) 10 (23.8%) How do you initially communicate the PC option to patients and families? 0.001 Refer to PC 35 (26.1%) 6 (15.8%) 13 (24.1%) 16 (38.1%) Do not address the issue 16 (11.9%) 2 (5.26%) 11 (20.4%) 3 (7.14%) Do not communicate 14 (10.4%) 0 (0.00%) 7 (13.0%) 7 (16.7%) Hold a meeting with the patient and/or family 69 (51.5%) 30 (78.9%) 23 (42.6%) 16 (38.1%) How confusing do you find the different terminologies used? 0.655 Confusing 116 (86.6%) 34 (89.5%) 45 (83.3%) 37 (88.1%) Not confusing 18 (13.4%) 4 (10.5%) 9 (16.7%) 5 (11.9%) PC referrals are an underutilized service. 0.003 Agree 89 (66.9%) 32 (86.5%) 27 (50.0%) 30 (71.4%) Disagree 16 (12.0%) 3 (8.11%) 8 (14.8%) 5 (11.9%) Neutral 28 (21.1%) 2 (5.41%) 19 (35.2%) 7 (16.7%) The multidisciplinary team should be more involved in end-of-life conversations. NC Disagree 1 (0.75%) 0 (0.00%) 0 (0.00%) 1 (2.38%) Neutral 1 (0.75%) 0 (0.00%) 1 (1.85%) 0 (0.00%) Agree 36 (27.1%) 14 (37.8%) 19 (35.2%) 3 (7.14%) Strongly agree 95 (71.4%) 23 (62.2%) 34 (63.0%) 38 (90.5%) More PC training should be provided for healthcare professionals. NC Neutral 2 (1.50%) 0 (0.00%) 1 (1.85%) 1 (2.38%) Agree 16 (12.0%) 4 (10.8%) 10 (18.5%) 2 (4.76%) Strongly agree 115 (86.5%) 33 (89.2%) 43 (79.6%) 39 (92.9%) NC = not calculated (little variation between responses). Chi-square Test Table 4 Comparison of perception regarding PC between senior participants (> 5 years of experience) and junior participants (< 5 years of experience) Question Junior Senior p-value Physicians When would you consider a referral to PC? 0.013 At the onset of symptoms 3 (30.0%) 1 (3.57%) When the disease becomes terminal 0 (0.00%) 10 (35.7%) When first diagnosed with a life-limiting illness 6 (60.0%) 16 (57.1%) If the family or patient demonstrates distress 1 (10.0%) 1 (3.57%) How confident are you in explaining the role of PC to patients? 0.650 Confident 9 (90.0%) 22 (78.6%) Not confident 1 (10.0%) 6 (21.4%) Nurses When would you consider a referral to PC? 0.244 At the onset of symptoms 0 (0.00%) 4 (11.1%) When the disease becomes terminal 9 (50.0%) 22 (61.10%) When first diagnosed with a life-limiting illness 8 (44.4%) 8 (22.2%) If the family or patient demonstrates distress 1 (5.56%) 2 (5.56%) How confident are you in explaining the role of PC to patients? 0.334 Confident 11 (61.1%) 28 (77.8%) Not confident 7 (38.9%) 8 (22.2%) Multi-team When would you consider a referral to PC? 0.715 At the onset of symptoms 4 (16.0%) 1 (5.88%) When the disease becomes terminal 5 (20.0%) 3 (17.6%) When first diagnosed with a life-limiting illness 16 (64.0%) 13 (76.5%) If the family or patient demonstrates distress 0 (0.00%) 0 (0.00%) How confident are you in explaining the role of PC to patients? 0.490 Confident 18 (72.0%) 14 82.4%) Not confident 7 (28.0%) 3 (17.6%) 1 Mean (Standard Deviation); median [first quartile; third quartile]. 1 Mann-Whitney Test, others, Chi-square test. # Category disregarded in the p-value Table 5 Comparison of perception regarding PC among participants based on their declared religion. Variable Total (n = 133) Catholic(n = 65) Spiritist (n = 14) Evangelical(n = 37) Others (n = 17) p-value Have you ever heard of the term dysthanasia? 0.423 No 23 (17.3%) 10 (15.4%) 1 (7.14%) 7 (18.9%) 5 (29.4%) Yes 110 (82.7%) 55 (84.6%) 13 (92.9%) 30 (81.1%) 12 (70.6%) In your view, when a patient is referred to PC, is there no indication for invasive measures? 0.538 No 46 (34.6%) 23 (35.4%) 5 (35.7%) 10 (27.0%) 8 (47.1%) Yes 87 (65.4%) 42 (64.6%) 9 (64.3%) 27 (73.0%) 9 (52.9%) When it is technically determined that the patient has no indication for invasive measures, do you: 0.538 Agree 123 (92.5%) 60 (92.3%) 12 (85.7%) 34 (91.9%) 17 (100%) Disagree 10 (7.52%) 5 (7.69%) 2 (14.3%) 3 (8.11%) 0 (0.00%) Do you have difficulty dealing with the topic of Death? 0.052 No 81 (60.4%) 33 (50.8%) 8 (57.1%) 29 (78.4%) 11 (64.7%) Yes 53 (39.6%) 32 (49.2%) 6 (42.9%) 8 (21.6%) 6 (35.3%) Chi-square Test Discussion As the world's population ages, the need for PC increases significantly. It is estimated that by 2050, over 2 billion people will be over 60 years old [ 10 ], many of whom will need PC at some point. The perception of healthcare professionals is crucial to ensure that PC is integrated into all stages of illness so that patients can live with dignity and respect until the end of life. This research was the first conducted in the hospital in question on this topic and makes a significant contribution by identifying gaps in perception and adherence to PC, which were not significantly different from data presented by other authors in studies conducted in various regions of the world [ 11 ]. The adherence rate to the questionnaire used to assess this perception was 9% of the population. Variance in adherence was noted in other studies [ 2 – 3 , 12 – 13 ]. The low questionnaire adherence in this research suggests the possibility that professionals not interested in PC may not have participated in the study. Additionally, 10.1% of the total number of doctors and 26.5% of nurses working in the hospital participated in the survey, despite the efforts made to disseminate information, which also leads us to assume that this topic remains taboo. Most participants were female, which is likely due to the gender distribution in the healthcare field, particularly in Nursing and other professions related to the healthcare and assistance sector [ 14 – 15 ]. The study revealed gaps in professional training, with many participants encountering the subject for the first time at the hospital where they work. Corroborating, Castro et al. [ 16 ] argue that there is a gap in PC education in the training of healthcare professionals. In Brazil, a significant step in physician training was recently taken with the approval of a resolution by the Ministry of Education, which included PC in the curriculum of undergraduate medical courses [ 17 ]. Apart from formal education, most of these participants did not receive knowledge on the subject through other channels, such as communication channels, family, or courses. Additionally, participants consider CP important for patients with various pathologies. The results indicated that, when comparing physicians and nurses, physicians tend to perceive palliative care as more beneficial for patients in a chronic critical condition. Additionally, physicians were better prepared regarding the timing of referrals to palliative care. This finding was expected, as physicians are responsible for referrals at this hospital. During the assessment of the patient's clinical condition, the findings indicated that the primary physician is the one who discusses treatment options. At this point, palliative care may be considered appropriate with the help of the palliative care physician. In addition, physicians play a key role in guiding the family and patient toward realistic approaches to the case, avoiding promoting ideas of futile treatments [ 18 ]. The multidisciplinary team demonstrated that they considered discharge planning and active management of the dying process to be the most important processes to be carried out. There was disagreement among professionals regarding the timing of referral to palliative care (Table 3 ). Physicians and the multidisciplinary team consider referral when the patient is first diagnosed with a life-limiting illness, while nurses prefer to do so when the illness becomes terminal. It is not possible to determine what led to these responses. In this study, regarding the communication about referral to PC, physicians are more likely to hold a meeting with the patient and/or family to provide guidance and information. At the same time, members of the multidisciplinary team tend to refer patients directly to PC. Otherwise, nurses meet with the patient and/or family, referring to PC and, in some cases, choosing not to address the issue initially. Such differences occur due to the role performed by each profession. In a study on the application of PC in the Netherlands [ 19 ], differences in perception between doctors and nurses, in particular, could be explained by their training. While doctors' training traditionally focuses on understanding diseases and their cures, nurses are trained in a holistic approach. Therefore, nurses may be better at identifying the need for PC. Among the strengths of this study, it is worth noting that it was the first conducted at this hospital on this topic, making a significant contribution by identifying gaps in the perception of and adherence to palliative care that could be addressed through educational initiatives involving the team. In the present study, there was almost unanimous agreement on the perception that a multidisciplinary team should be included in end-of-life conversations. Additionally, the majority agree that PC services are underutilized in that hospital. One positive aspect is that the majority feel confident in explaining the role of PC to patients. However, the exact method and quality of these explanations are unknown. A study involving patients and families to assess their understanding would be necessary to address this gap. Additionally, the general public lacks sufficient prior knowledge about PCs and heavily relies on these explanations, despite finding the terminology confusing. Professionals who feel confident explaining PC to families also express concerns about this issue. They suggest more training in PC for healthcare professionals, highlighting the importance of continuous education to clarify any doubts about the topic. Participants' confidence in explaining PC and their timing of referral to PC were compared. Senior and Junior nursing professionals, as well as the multidisciplinary team, showed no difference in confidence levels or referral timing (Table 4 ). However, physicians differed significantly in their preferred timing for referral, with Junior physicians advocating for earlier referral, aligning with recommendations from the Brazilian National Association of PC (ANCP). Confidence in explaining PC did not vary between Senior and Junior physicians. Additionally, a comparative analysis explored participants' perceptions of PC based on their religious beliefs (Table 5 ). This analysis aimed to understand how religious beliefs might influence healthcare professionals' views and approaches to PC. There was no significant association found between religion and various questions related to PC awareness and attitudes, including familiarity with the term "dysthanasia", beliefs about invasive measures in PC, agreement with technical definitions, and difficulty in dealing with death. Cultural factors and religious beliefs may have influenced individuals' perceptions regarding PC, as highlighted in studies by Carmo et al. [ 20 ] and Kubitza et al. [ 21 ]. It will be important to apply a new questionnaire in a few years to observe the evolution and adherence to the theme, especially when considering the possibility of a new scenario after the implementation and consolidation of new medical school curricula in Brazil, which should include the approach to Family Medicine. Understanding and discussing PC is crucial in preventing futile treatments. Chamberlain et al. [ 22 ] found that most physicians in New York City reported providing or considering futile care, often due to pressure from family members. This situation is linked to physician burnout and can lead to avoidance of both patients and their families. Consequently, patients receive reduced care, and families face isolation during a vulnerable time. A solid grasp of PC principles empowers healthcare professionals to make ethical decisions, avoiding unnecessary patient discomfort. Responses varied regarding the greatest barrier to recommending patient referral for consultation with PC. It can be inferred that the patient's and family's view of PC was the most frequently cited concern, followed by difficulty defining any prognosis and personal uncertainties about what PC entails. PC is relatively new in healthcare systems, especially in low- and middle-income countries. A public health approach is needed to promote the development of PC services and overcome existing barriers in each country. Legal knowledge about the application of CP is essential to support professional practice, and this still represents a gap in professional training [ 23 ]. Significant global barriers include the lack of clear policies establishing PC, the absence of educational programs, the scarcity of research on the topic, the shortage of essential medications, and the absence of organized programs to provide PC. All these barriers can be overcome. Existing resources can be adapted to meet the needs of each country to fill these gaps. What is needed is the willingness to do so and the recognition that the lack of PC is a problem that leads to unnecessary suffering for those who are among the most vulnerable in society [ 24 ]. Even the name given to the service has been subject to reassessment; some health professionals significantly prefer the name "supportive care" because it causes less suffering and brings hope. Palliative care can be considered part of supportive care [ 25 ]. Low adherence to PC services reflects a lack of interest and knowledge about PC within the hospital, leading to its underutilization. To bridge these gaps, authorities, healthcare professionals, and society must collaborate to enhance the understanding and accessibility of PC for all in need. Looking forward, initiatives to integrate PC education and practice are vital for ensuring equitable access to quality end-of-life care. It involves integrating PC principles into medical school courses, fostering interdisciplinary collaboration, and nurturing open communication and shared decision-making among healthcare providers, patients, and families. Addressing these challenges and leveraging opportunities for improvement will enable healthcare systems to meet better the evolving needs of individuals facing serious illnesses, promoting dignity, comfort, and compassion throughout their journey. The study's contributions are directly relevant to the hospital where the data were collected, as they reflect professional opinions, knowledge gaps, and challenges to be addressed. Additionally, they can serve as a valuable starting point for future studies and provide useful insights to inform public policies and professional training. The limitations of the study include the fact that only a portion of the professionals responded to the questionnaire. It is assumed that this may reflect that only professionals with some interest in CP participated, although this is merely speculation on the part of the authors. Based on the findings, to improve palliative care, it is suggested to invest in continuing education and interdisciplinary training, promoting integration and communication between multidisciplinary teams, raising awareness about the role of palliative care for patients and families, improving access to information and palliative care services, encouraging institutional and public policies for palliative care, and promoting research and continuous evaluation. In short, educational actions, integration between teams, awareness raising, institutional policies, and constant evaluation are necessary to improve palliative care. Conclusion It was found that professional training influences decisions regarding palliative care. The main gaps in perception, knowledge, and adherence identified in the context of palliative care were confusion regarding the conceptual understanding of palliative care, concerns about patient and family opinions, and uncertainty about the optimal timing to initiate palliative care. Educational initiatives, team integration, awareness raising, institutional policies, and ongoing evaluation can be necessary to improve palliative care. Declarations Funding This research was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) - Brazil. Conflicts of Interest The authors declare no conflicts of interest. Ethics Approval The study was approved by the PUC-Campinas Human Research Ethics Committee (reference number 5.494.431). Consent to participate The patient consent statement was obtained online from all the individuals involved in the study. Written Consent for publication Not applicable Availability of data and material The data that support the findings of this study are available from the corresponding author upon reasonable request. Code availability Not applicable Authors' contributions JCRM was responsible for the study conception and design, data collection, data analysis, and manuscript drafting. GMSG supervised the study, contributed to the study design, data interpretation, and critically revised the manuscript. Both authors read and approved the final manuscript. References Gonçalves F, Gaudêncio M, Rocha A, Paiva I, Rego F, Nunes R. A Review on the Management of Symptoms in Patients with Incurable Cancer. Curr Oncol. 2025;32(8):433. Kyc SJ, Bruno CJ, Shabanova V, Montgomery AM. Perceptions of Neonatal Palliative Care: Similarities and Differences between Medical and Nursing Staff in a Level IV Neonatal Intensive Care Unit. J Palliat Med. 2020;23(5):662–9. Yu J, Song IG, Kim CH, Moon YJ, Shin HY, Kim MS. 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Barriers to Effective Communication about Advance Care Planning and Palliative Care: A Qualitative Study. J Hosp Palliat Care. 2023;26:42–50. Tay J, Compton S, Phua G, Zhuang Q, Neo S, Lee G, et al. Perceptions of healthcare professionals towards palliative care in internal medicine wards: a cross-sectional survey. BMC Palliat Care. 2021;20(1):101. UN. World population projected to reach 9.8 billion in 2050, and 11.2 billion in 2100. [Internet]. 2024 [cited 2024 Jun 12] Available from: https://www.un.org/en/desa/world-population-projected-reach-98-billion-2050-and-112-billion-2100 De-Clercq E, Rost M, Rakic M, Ansari M, Brazzola P, Wangmo T, et al. The conceptual understanding of pediatric palliative care: a Swiss healthcare perspective. BMC Palliat Care. 2019;18(1):55. Bar B, Creutzfeldt CJ, Rubin MA. Palliative Care in the Neuro-ICU: Perceptions, Practice Patterns, and Preferences of Neurointensivists. Neurocrit Care. 2020;32(1):302–5. Hahne J, Wang X, Liu R, Zhong Y, Chen X, Liu X, et al. Chinese physicians' perceptions of palliative care integration for advanced cancer patients: a qualitative analysis at a tertiary hospital in Changsha, China. BMC Med Ethics. 2020;23(1):17. Souza HS, Trapé CA, Campos CMS, Soares CB. The Brazilian nursing workforce faced with the international trends: an analysis in the International Year of Nursing. Physis: Revista de Saúde Coletiva. 2021;31:e310111. Scheffer M, Guerra A, Cassenote A, Guilloux AGA, Brandão APD, Miotto BA et al. Conselho Federal de Medicina. Demografia médica no Brasil-2020. [Internet]. 2020 [cited 2024 Jun 12] 312 p. Available from: https://docs.bvsalud.org/biblioref/2023/06/1436680/issue-7ffb4e0ece07869880d51662a2234143.pdf Castro AA, Taquette SR, Pereira CAR, Marques NI. Palliative care in medical education: the students’ perception. Rev Bras Educ Med. 2022;46(1):e024. Conselho Nacional de Educação (Br). Câmara de Educação Superior. Resolução CNE/CES Nº 3, de 3 de novembro de 2022. [Internet]. 2022 [cited 2024 Jun 12] Available from: http://portal.mec.gov.br/index.php?option=com_docman&view=download&alias=242251-rces003-22-2&category_slug=novembro-2022-pdf-1&Itemid=30192 Weiss Goitiandia S, Sun AZ, Rosenwohl-Mack A, Ly C, Sleeman KE, Dohan D, Dzeng E. Systemic Strategies to Prevent Nonbeneficial Treatments Near the End of Life. JAMA Netw Open. 2025;8(7):e2519771. 10.1001/jamanetworkopen.2025.19771 . Flierman I, Nugteren IC, Van Seben R. How do hospital-based nurses and physicians identify the palliative phase in their patients and what difficulties exist? A qualitative interview study. BMC Palliat Care. 2019;18:54. Carmo BDS, Camargo MG, Santos Neto MFD, Paiva BSR, Lucchetti G, Paiva CE. Relationship Between Religion/Spirituality and the Aggressiveness of Cancer Care: A Scoping Review. J Pain Symptom Manage. 2023;65(5):e425–37. Kubitza J, GROßE G, Schütte-Nütgen K, Frick E. Influence of spirituality on moral distress and resilience in critical care staff: A scoping review. Intensive Crit Care Nurs. 2023;76:103377. Chamberlin P, Lambden J, Kozlov E, Maciejewski R, Lief L, Berlin DA, et al. Clinicians' Perceptions of Futile or Potentially Inappropriate Care and Associations with Avoidant Behaviors and Burnout. J Palliat Med. 2019;22(9):1039–45. Schumann C, Wachter M, Eslauer E, Angeli R, Girrbach F, Weiss M, Friedrich S, Simon P, Heller AR. Do professional experience and qualification influence knowledge about law concerning informed consent and end-of-life decisions? A quantitative online survey among German intensive care physicians. BMJ Open. 2025;15(12):e104548. 10.1136/bmjopen-2025-104548 . Tripodoro VA, et al. First-Ever Global Ranking of Palliative Care: 2025 World Map Under the New WHO Framework. J Pain Symptom Manag. 2025;70(5):447–58. Taylor A, Davies A. Palliative care or supportive care? Clin Med 2025; 100487. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 04 May, 2026 Reviews received at journal 03 May, 2026 Reviews received at journal 02 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers agreed at journal 01 May, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviewers agreed at journal 29 Apr, 2026 Reviewers invited by journal 13 Apr, 2026 Editor assigned by journal 13 Apr, 2026 Submission checks completed at journal 13 Apr, 2026 First submitted to journal 12 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9394500","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":625421042,"identity":"c597188f-c78e-4b34-a081-a51d2658c2f9","order_by":0,"name":"Jane Christine Rodrigues Magalhães¹","email":"data:image/png;base64,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","orcid":"","institution":"Pontifical Catholic University of Campinas (PUC-Campinas)","correspondingAuthor":true,"prefix":"","firstName":"Jane","middleName":"Christine Rodrigues","lastName":"Magalhães¹","suffix":""},{"id":625421043,"identity":"fa335080-0d14-4e98-89d4-07f21bee0423","order_by":1,"name":"Gisele Mara Silva Gonçalves¹","email":"","orcid":"","institution":"Pontifical Catholic University of Campinas (PUC-Campinas)","correspondingAuthor":false,"prefix":"","firstName":"Gisele","middleName":"Mara Silva","lastName":"Gonçalves¹","suffix":""}],"badges":[],"createdAt":"2026-04-12 13:23:38","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9394500/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9394500/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":107486118,"identity":"272e1073-a7b6-4ef0-bb23-6d6215c95499","added_by":"auto","created_at":"2026-04-22 02:37:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":961880,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9394500/v1/b07d8ba9-29d3-4a07-852f-c71ab81cd73f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Knowledge and Adherence to Palliative Care Practices","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn the face of the complex and challenging nature of life-threatening illnesses, whether acute or chronic and regardless of the possibility of reversal or curative treatment, healthcare professionals are tasked with providing a comprehensive and complex approach that prioritizes the overall well-being of the patient while also considering the suffering of their family. It is a significant challenge for both public and private healthcare sectors in Brazil and globally [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. As professionals navigate this intricate landscape, palliative care (PC) emerges as an increasingly prevalent and indispensable approach in their practice.\u003c/p\u003e \u003cp\u003eThe perception of PC among healthcare professionals varies and is influenced by various factors, including cultural context, professional training, and access to resources. Globally, understanding and acceptance of PC have evolved, but significant challenges remain [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Studies, such as that of Burt et al. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], highlight that some healthcare professionals may encounter barriers to addressing PC, such as a lack of specific training or concerns about sensitive communication with patients and their families regarding end-of-life issues.\u003c/p\u003e \u003cp\u003eIn the Brazilian context, these challenges are compounded by unique cultural and organizational barriers that shape the perception and delivery of PC. According to Magalh\u0026atilde;es et al. (2024), cultural misconceptions, such as the association of PC with giving up on curative treatment, hinder its broader acceptance. Organizational factors, including inadequate institutional support and fragmented care systems, further complicate the integration of PC into routine healthcare practice. These barriers not only limit the effectiveness of PC but also exacerbate disparities in access to and quality of care for patients facing life-threatening illnesses.\u003c/p\u003e \u003cp\u003eWell-trained healthcare professionals tend to have a more holistic understanding of PC, recognizing its importance not only in pain management but also in emotional support, open communication, and promotion of patient dignity during the end-of-life phase. Furthermore, ongoing education and development of specific skills in PC are essential to improve the delivery of these services. A crucial challenge faced by healthcare professionals worldwide is the need for an integrated and coordinated approach among different medical specialties, nursing, social work, and other professionals to offer effective PC [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The perception of PC among healthcare professionals is constantly evolving, reflecting changes in health policies, advances in medical education, and public awareness of the importance of these services.\u003c/p\u003e \u003cp\u003eAccording to the Brazilian ANCP (National Academy of PC), a considerable lack of awareness and prejudice related to PC still exists in Brazil, particularly among physicians, healthcare professionals, and hospital managers. PC is still often confused with euthanasia, and there is significant prejudice regarding the use of opioids such as morphine for pain relief [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Discomfort among professionals, physician resistance, and insufficient knowledge among the team regarding advanced care planning in patients with PC were identified [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGiven this scenario, the present study becomes relevant because, upon analyzing the results, it is possible to either refute or corroborate the assertion above regarding the participating professionals. This is particularly relevant, considering that the research was conducted in a teaching hospital that serves as a professional training center.\u003c/p\u003e \u003cp\u003e The primary objective of this study was to evaluate and compare the perceptions of healthcare professionals from various areas who care for patients requiring palliative care at a university hospital in Campinas, S\u0026atilde;o Paulo, Brazil. The specific objectives included analyzing the academic background of the study population and assessing whether there is a correlation between understanding and adherence to the palliative care approach, as well as identifying areas for improvement in perception, knowledge, and adherence in the care provided to individuals in the context of palliative care. The initial hypothesis was that professionals' knowledge of palliative care was insufficient and could vary according to profession.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design\u003c/p\u003e \u003cp\u003eAn observational study that used the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) instrument to guide the methodology.\u003c/p\u003e \u003cp\u003eSampling strategy\u003c/p\u003e \u003cp\u003eThe total number of potential participants was 1,474 individuals, including 828 nursing technicians, 375 physicians, 207 nurses, 38 physiotherapists, 11 social workers, nine nutritionists, four psychologists, and two occupational therapists, among others. A total of 136 individuals responded to the questionnaire, and after applying inclusion and exclusion criteria, the sample consisted of 134 participants.\u003c/p\u003e \u003cp\u003eParticipants were grouped into three categories for comparison: physicians (n\u0026thinsp;=\u0026thinsp;38), nurses (n\u0026thinsp;=\u0026thinsp;54), and other multidisciplinary team members, including social workers, physiotherapists, nutritionists, psychologists, occupational therapists, and others (n\u0026thinsp;=\u0026thinsp;42).\u003c/p\u003e \u003cp\u003eInclusion and exclusion criteria\u003c/p\u003e \u003cp\u003e The study participants were hospital employees from various healthcare areas who agreed to participate by signing an informed consent form. The following were excluded: university students and professionals from other hospital sectors who were not directly involved in patient care.\u003c/p\u003e \u003cp\u003eData collection\u003c/p\u003e \u003cp\u003eData collection was performed using an online questionnaire based on the instrument used by Tay et al. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. There were 38 multiple-choice questions (demographic data collection and questions assessing PC perception). Responses were tabulated using categorical scales appropriate for statistical analysis. The questionnaire was formulated on a five-point Likert scale. Data collection took place in the last quarter of 2022.\u003c/p\u003e \u003cp\u003eAnalysis of results\u003c/p\u003e \u003cp\u003eThe profiles of the participants, their knowledge and perceptions of CP in the three groups, and their self-reported behaviors related to CP were analyzed comparatively. A comparison of perceptions between senior and junior participants was also performed.\u003c/p\u003e \u003cp\u003eStatistical analysis was performed using R\u0026reg; software. An exploratory data analysis was conducted, employing summary measures (mean, standard deviation, median, first quartile, third quartile, frequency, and percentage). The association between categorical variables was evaluated using the Chi-square test. In contrast, comparisons between groups regarding numerical variables were performed using the Kruskal-Wallis or Mann-Whitney test, as appropriate. For all analyses, a significance level of 5% was considered. Sample power was analyzed based on two questions selected for relevance: \"How much do you think critically ill patients will benefit from PC?\" and \"When would you consider a referral to PC?\" The percentages obtained were 81.4% and 98.6%, respectively, indicating that the sample is sufficient for comparing professional groups.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn summary, the median age of the participants was 34 years, with women comprising 87% of the group (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Most identified themselves as Catholic or Evangelical, with less than 5 years of professional training. In addition, many reported interactions with terminally ill patients, even without specific training in palliative care. The multidisciplinary team is younger than the teams of physicians and nurses (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with less professional experience (p-value\u0026thinsp;=\u0026thinsp;0.004). The hospital's palliative care service is better known among physicians than among nurses (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Regarding religion, there were more Catholic physicians and more evangelical nurses (p-value\u0026thinsp;=\u0026thinsp;0.002), more female physicians (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and fewer nurses with any training in palliative care (p-value\u0026thinsp;=\u0026thinsp;0.021).\u003c/p\u003e \u003cp\u003eMost participants consider palliative care to be extremely important in the treatment and management of patients in the final stages of life (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Similarly, most believe that frail elderly patients, cancer patients, patients with organ failure, and neurological patients with severe sequelae will benefit significantly from this approach.\u003c/p\u003e \u003cp\u003eThere were differences in the response to the question \"When would you consider a referral to palliative care?\" (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001). While physicians and multidisciplinary teams tend to consider this referral when the patient is first diagnosed with a life-limiting illness, nurses, on the other hand, generally choose to refer when the disease is already in its terminal stage (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDifferences were also found among professionals in \"How do you first communicate the option of palliative care to patients and family members?\" (p-value\u0026thinsp;=\u0026thinsp;0.001). Physicians are more likely to hold a meeting with the patient and/or family, while multidisciplinary teams tend to refer directly to palliative care. Nurses, on the other hand, are divided between holding a meeting with the patient and/or family, referring to palliative care, and not addressing the issue at all (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding \"Palliative care referrals are an underutilized service\" (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e), nurses agree less with this statement than physicians and multidisciplinary teams (p-value\u0026thinsp;=\u0026thinsp;0.003).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant profile regarding demographic data and PC knowledge by profession.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAge\u003csup\u003e1\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;134)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysician (n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMulti-team (n\u0026thinsp;=\u0026thinsp;42)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34.0 [26.0;42.0]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.0 [29.0;48.5]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.0 [27.0;42.0]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.0 [24.0;33.0]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116 (86.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (63.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52 (96.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e40 (95.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (36.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2 (3.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2 (4.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReligion\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCatholic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e65 (48.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25 (67.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (37.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20 (47.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpiritist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (8.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4 (9.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEvangelical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12 (28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17 (12.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (7.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessional Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;5 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53 (39.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (26.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25 (59.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (17.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (13.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (31.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20 (37.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21 (15.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (28.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5 (9.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you have any training in PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e100 (74.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24 (63.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47 (87.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29 (69.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34 (25.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (36.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13 (31.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhere did you learn about PC? a) Undergraduate:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64 (47.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (42.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (57.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17 (40.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70 (52.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (57.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25 (59.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eb) Work:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (20.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9 (21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107 (79.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (81.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e33 (78.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ec) Courses:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.667\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75 (56.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32 (59.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24 (57.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59 (44.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22 (40.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18 (42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ed) Communication:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.301\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97 (72.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (68.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43 (79.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28 (66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (27.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (31.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ee) Family:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.530\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115 (85.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (86.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48 (88.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e34 (81.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (14.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5 (13.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8 (19.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow often do you interact with terminally ill patients?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.099\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (7.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27 (20.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (7.89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12 (28.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrequently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40 (29.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12 (31.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13 (31.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery frequently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (36.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (29.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAre you familiar with the PC service at this hospital?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (26.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e99 (73.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (94.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003csup\u003e1\u003c/sup\u003eExpressed as median [first quartile; third quartile]. Age: Kruskal-Wallis test. Other tests: Chi-square.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipants' perceptions of PC by profession.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWhat is the importance of the role of PC in the treatment/management of terminal patients?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;134)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysician (n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMulti-team (n\u0026thinsp;=\u0026thinsp;42)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.325\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImportant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (3.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (5.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e129 (96.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36 (94.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51 (94.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think frail elderly patients will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.378\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (91.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44 (81.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (8.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think patients with dementia/Parkinson's disease will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.067\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e105 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (91.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39 (72.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32 (76.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (8.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (23.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think cancer patients will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.752\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124 (93.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (94.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51 (94.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38 (90.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9 (6.77%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (5.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (9.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think Patients with organ failure will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.735\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e114 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (89.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think patients with severe neurological sequelae will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.275\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117 (88.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (94.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37 (88.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow much do you think critically ill patients will benefit from PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery beneficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107 (80.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (94.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38 (70.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (81.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (29.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (19.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eChi-square Test. Other: grouping of categories that presented a low number of responses for statistical analysis feasibility (4 beneficial\u0026thinsp;+\u0026thinsp;3 somewhat beneficial; 2 not so beneficial\u0026thinsp;+\u0026thinsp;1 not beneficial) or (4 important\u0026thinsp;+\u0026thinsp;3 somewhat important; 2 not so important\u0026thinsp;+\u0026thinsp;1 not important).\"\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSelf-reported behaviors regarding PC by profession.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eWhen would you consider a referral to PC?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;134)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysician (n\u0026thinsp;=\u0026thinsp;38)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;54)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMulti-team (n\u0026thinsp;=\u0026thinsp;42)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt the onset of symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13 (9.70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4 (7.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen the disease becomes terminal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (36.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10 (26.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31 (57.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8 (19.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen first diagnosed with a life-limiting illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (57.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16 (29.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29 (69.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf the family or patient demonstrates distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5 (3.73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (5.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow confident are you in explaining the role of PC to patients?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.584\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e102 (76.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31 (81.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39 (72.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32 (76.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot confident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32 (23.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7 (18.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15 (27.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10 (23.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow do you initially communicate the PC option to patients and families?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRefer to PC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35 (26.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (15.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (24.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (38.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not address the issue\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.26%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (20.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (7.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not communicate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (10.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHold a meeting with the patient and/or family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69 (51.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (78.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23 (42.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (38.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow confusing do you find the different terminologies used?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.655\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfusing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e116 (86.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34 (89.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37 (88.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot confusing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18 (13.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePC referrals are an underutilized service.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e89 (66.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32 (86.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30 (71.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (8.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (14.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (11.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28 (21.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2 (5.41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (35.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe multidisciplinary team should be more involved in end-of-life conversations.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1 (2.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1 (0.75%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36 (27.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (37.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e19 (35.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3 (7.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e95 (71.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23 (62.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34 (63.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38 (90.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore PC training should be provided for healthcare professionals.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNC\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (1.50%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (1.85%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1 (2.38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (12.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4 (10.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (18.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2 (4.76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115 (86.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (89.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43 (79.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e39 (92.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eNC\u0026thinsp;=\u0026thinsp;not calculated (little variation between responses). Chi-square Test\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of perception regarding PC between senior participants (\u0026gt;\u0026thinsp;5 years of experience) and junior participants (\u0026lt;\u0026thinsp;5 years of experience)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQuestion\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eJunior\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSenior\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003ePhysicians\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen would you consider a referral to PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt the onset of symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (30.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen the disease becomes terminal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen first diagnosed with a life-limiting illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (60.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (57.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf the family or patient demonstrates distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (3.57%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow confident are you in explaining the role of PC to patients?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.650\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (90.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (78.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot confident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (10.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (21.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eNurses\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen would you consider a referral to PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.244\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt the onset of symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (11.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen the disease becomes terminal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9 (50.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (61.10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen first diagnosed with a life-limiting illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (44.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf the family or patient demonstrates distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (5.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (5.56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow confident are you in explaining the role of PC to patients?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.334\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (61.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28 (77.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot confident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (38.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (22.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eMulti-team\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen would you consider a referral to PC?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt the onset of symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (16.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (5.88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen the disease becomes terminal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen first diagnosed with a life-limiting illness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16 (64.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (76.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf the family or patient demonstrates distress\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow confident are you in explaining the role of PC to patients?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.490\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (72.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14 82.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot confident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (28.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (17.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003e1\u003c/sup\u003e Mean (Standard Deviation); median [first quartile; third quartile]. \u003csup\u003e1\u003c/sup\u003e Mann-Whitney Test, others, Chi-square test. \u003csup\u003e#\u003c/sup\u003e Category disregarded in the p-value\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of perception regarding PC among participants based on their declared religion.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (n\u0026thinsp;=\u0026thinsp;133)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCatholic(n\u0026thinsp;=\u0026thinsp;65)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eSpiritist (n\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEvangelical(n\u0026thinsp;=\u0026thinsp;37)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOthers (n\u0026thinsp;=\u0026thinsp;17)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave you ever heard of the term dysthanasia?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23 (17.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (15.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003cp\u003e(7.14%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003cp\u003e(18.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003cp\u003e(29.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110 (82.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (84.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (92.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (81.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (70.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIn your view, when a patient is referred to PC, is there no indication for invasive measures?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46 (34.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (35.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003cp\u003e(35.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10 (27.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(47.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87 (65.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 (64.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e(64.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (73.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9\u003c/p\u003e \u003cp\u003e(52.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhen it is technically determined that the patient has no indication for invasive measures, do you:\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.538\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123 (92.5%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (92.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (85.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34 (91.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10 (7.52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003cp\u003e(7.69%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003cp\u003e(14.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003cp\u003e(8.11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003cp\u003e(0.00%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you have difficulty dealing with the topic of Death?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81 (60.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33 (50.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(57.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29 (78.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (64.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53 (39.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (49.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e(42.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003cp\u003e(21.6%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003cp\u003e(35.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eChi-square Test\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAs the world's population ages, the need for PC increases significantly. It is estimated that by 2050, over 2\u0026nbsp;billion people will be over 60 years old [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], many of whom will need PC at some point. The perception of healthcare professionals is crucial to ensure that PC is integrated into all stages of illness so that patients can live with dignity and respect until the end of life. This research was the first conducted in the hospital in question on this topic and makes a significant contribution by identifying gaps in perception and adherence to PC, which were not significantly different from data presented by other authors in studies conducted in various regions of the world [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe adherence rate to the questionnaire used to assess this perception was 9% of the population. Variance in adherence was noted in other studies [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The low questionnaire adherence in this research suggests the possibility that professionals not interested in PC may not have participated in the study. Additionally, 10.1% of the total number of doctors and 26.5% of nurses working in the hospital participated in the survey, despite the efforts made to disseminate information, which also leads us to assume that this topic remains taboo.\u003c/p\u003e \u003cp\u003eMost participants were female, which is likely due to the gender distribution in the healthcare field, particularly in Nursing and other professions related to the healthcare and assistance sector [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe study revealed gaps in professional training, with many participants encountering the subject for the first time at the hospital where they work. Corroborating, Castro et al. [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] argue that there is a gap in PC education in the training of healthcare professionals. In Brazil, a significant step in physician training was recently taken with the approval of a resolution by the Ministry of Education, which included PC in the curriculum of undergraduate medical courses [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Apart from formal education, most of these participants did not receive knowledge on the subject through other channels, such as communication channels, family, or courses. Additionally, participants consider CP important for patients with various pathologies.\u003c/p\u003e \u003cp\u003eThe results indicated that, when comparing physicians and nurses, physicians tend to perceive palliative care as more beneficial for patients in a chronic critical condition. Additionally, physicians were better prepared regarding the timing of referrals to palliative care. This finding was expected, as physicians are responsible for referrals at this hospital. During the assessment of the patient's clinical condition, the findings indicated that the primary physician is the one who discusses treatment options. At this point, palliative care may be considered appropriate with the help of the palliative care physician. In addition, physicians play a key role in guiding the family and patient toward realistic approaches to the case, avoiding promoting ideas of futile treatments [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The multidisciplinary team demonstrated that they considered discharge planning and active management of the dying process to be the most important processes to be carried out.\u003c/p\u003e \u003cp\u003eThere was disagreement among professionals regarding the timing of referral to palliative care (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Physicians and the multidisciplinary team consider referral when the patient is first diagnosed with a life-limiting illness, while nurses prefer to do so when the illness becomes terminal. It is not possible to determine what led to these responses.\u003c/p\u003e \u003cp\u003eIn this study, regarding the communication about referral to PC, physicians are more likely to hold a meeting with the patient and/or family to provide guidance and information. At the same time, members of the multidisciplinary team tend to refer patients directly to PC. Otherwise, nurses meet with the patient and/or family, referring to PC and, in some cases, choosing not to address the issue initially. Such differences occur due to the role performed by each profession. In a study on the application of PC in the Netherlands [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], differences in perception between doctors and nurses, in particular, could be explained by their training. While doctors' training traditionally focuses on understanding diseases and their cures, nurses are trained in a holistic approach. Therefore, nurses may be better at identifying the need for PC.\u003c/p\u003e \u003cp\u003eAmong the strengths of this study, it is worth noting that it was the first conducted at this hospital on this topic, making a significant contribution by identifying gaps in the perception of and adherence to palliative care that could be addressed through educational initiatives involving the team.\u003c/p\u003e \u003cp\u003eIn the present study, there was almost unanimous agreement on the perception that a multidisciplinary team should be included in end-of-life conversations. Additionally, the majority agree that PC services are underutilized in that hospital.\u003c/p\u003e \u003cp\u003eOne positive aspect is that the majority feel confident in explaining the role of PC to patients. However, the exact method and quality of these explanations are unknown. A study involving patients and families to assess their understanding would be necessary to address this gap. Additionally, the general public lacks sufficient prior knowledge about PCs and heavily relies on these explanations, despite finding the terminology confusing. Professionals who feel confident explaining PC to families also express concerns about this issue. They suggest more training in PC for healthcare professionals, highlighting the importance of continuous education to clarify any doubts about the topic.\u003c/p\u003e \u003cp\u003eParticipants' confidence in explaining PC and their timing of referral to PC were compared. Senior and Junior nursing professionals, as well as the multidisciplinary team, showed no difference in confidence levels or referral timing (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). However, physicians differed significantly in their preferred timing for referral, with Junior physicians advocating for earlier referral, aligning with recommendations from the Brazilian National Association of PC (ANCP). Confidence in explaining PC did not vary between Senior and Junior physicians. Additionally, a comparative analysis explored participants' perceptions of PC based on their religious beliefs (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This analysis aimed to understand how religious beliefs might influence healthcare professionals' views and approaches to PC.\u003c/p\u003e \u003cp\u003eThere was no significant association found between religion and various questions related to PC awareness and attitudes, including familiarity with the term \"dysthanasia\", beliefs about invasive measures in PC, agreement with technical definitions, and difficulty in dealing with death. Cultural factors and religious beliefs may have influenced individuals' perceptions regarding PC, as highlighted in studies by Carmo et al. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and Kubitza et al. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIt will be important to apply a new questionnaire in a few years to observe the evolution and adherence to the theme, especially when considering the possibility of a new scenario after the implementation and consolidation of new medical school curricula in Brazil, which should include the approach to Family Medicine.\u003c/p\u003e \u003cp\u003eUnderstanding and discussing PC is crucial in preventing futile treatments. Chamberlain et al. [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] found that most physicians in New York City reported providing or considering futile care, often due to pressure from family members. This situation is linked to physician burnout and can lead to avoidance of both patients and their families. Consequently, patients receive reduced care, and families face isolation during a vulnerable time. A solid grasp of PC principles empowers healthcare professionals to make ethical decisions, avoiding unnecessary patient discomfort.\u003c/p\u003e \u003cp\u003eResponses varied regarding the greatest barrier to recommending patient referral for consultation with PC. It can be inferred that the patient's and family's view of PC was the most frequently cited concern, followed by difficulty defining any prognosis and personal uncertainties about what PC entails.\u003c/p\u003e \u003cp\u003ePC is relatively new in healthcare systems, especially in low- and middle-income countries. A public health approach is needed to promote the development of PC services and overcome existing barriers in each country. Legal knowledge about the application of CP is essential to support professional practice, and this still represents a gap in professional training [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSignificant global barriers include the lack of clear policies establishing PC, the absence of educational programs, the scarcity of research on the topic, the shortage of essential medications, and the absence of organized programs to provide PC. All these barriers can be overcome. Existing resources can be adapted to meet the needs of each country to fill these gaps. What is needed is the willingness to do so and the recognition that the lack of PC is a problem that leads to unnecessary suffering for those who are among the most vulnerable in society [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Even the name given to the service has been subject to reassessment; some health professionals significantly prefer the name \u003cem\u003e\"supportive care\"\u003c/em\u003e because it causes less suffering and brings hope. Palliative care can be considered part of supportive care [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eLow adherence to PC services reflects a lack of interest and knowledge about PC within the hospital, leading to its underutilization. To bridge these gaps, authorities, healthcare professionals, and society must collaborate to enhance the understanding and accessibility of PC for all in need.\u003c/p\u003e \u003cp\u003eLooking forward, initiatives to integrate PC education and practice are vital for ensuring equitable access to quality end-of-life care. It involves integrating PC principles into medical school courses, fostering interdisciplinary collaboration, and nurturing open communication and shared decision-making among healthcare providers, patients, and families. Addressing these challenges and leveraging opportunities for improvement will enable healthcare systems to meet better the evolving needs of individuals facing serious illnesses, promoting dignity, comfort, and compassion throughout their journey.\u003c/p\u003e \u003cp\u003eThe study's contributions are directly relevant to the hospital where the data were collected, as they reflect professional opinions, knowledge gaps, and challenges to be addressed. Additionally, they can serve as a valuable starting point for future studies and provide useful insights to inform public policies and professional training.\u003c/p\u003e \u003cp\u003eThe limitations of the study include the fact that only a portion of the professionals responded to the questionnaire. It is assumed that this may reflect that only professionals with some interest in CP participated, although this is merely speculation on the part of the authors.\u003c/p\u003e \u003cp\u003eBased on the findings, to improve palliative care, it is suggested to invest in continuing education and interdisciplinary training, promoting integration and communication between multidisciplinary teams, raising awareness about the role of palliative care for patients and families, improving access to information and palliative care services, encouraging institutional and public policies for palliative care, and promoting research and continuous evaluation. In short, educational actions, integration between teams, awareness raising, institutional policies, and constant evaluation are necessary to improve palliative care.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIt was found that professional training influences decisions regarding palliative care. The main gaps in perception, knowledge, and adherence identified in the context of palliative care were confusion regarding the conceptual understanding of palliative care, concerns about patient and family opinions, and uncertainty about the optimal timing to initiate palliative care. Educational initiatives, team integration, awareness raising, institutional policies, and ongoing evaluation can be necessary to improve palliative care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES) - Brazil.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no conflicts of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the PUC-Campinas Human Research Ethics Committee (reference number 5.494.431).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe patient consent statement was obtained online from all the individuals involved in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWritten Consent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJCRM was responsible for the study conception and design, data collection, data analysis, and manuscript drafting. GMSG supervised the study, contributed to the study design, data interpretation, and critically revised the manuscript. Both authors read and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGon\u0026ccedil;alves F, Gaud\u0026ecirc;ncio M, Rocha A, Paiva I, Rego F, Nunes R. A Review on the Management of Symptoms in Patients with Incurable Cancer. Curr Oncol. 2025;32(8):433.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKyc SJ, Bruno CJ, Shabanova V, Montgomery AM. Perceptions of Neonatal Palliative Care: Similarities and Differences between Medical and Nursing Staff in a Level IV Neonatal Intensive Care Unit. J Palliat Med. 2020;23(5):662\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYu J, Song IG, Kim CH, Moon YJ, Shin HY, Kim MS. Perceptions of Pediatric Palliative Care among Physicians Who Care for Pediatric Patients in South Korea. 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A quantitative online survey among German intensive care physicians. BMJ Open. 2025;15(12):e104548. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bmjopen-2025-104548\u003c/span\u003e\u003cspan address=\"10.1136/bmjopen-2025-104548\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTripodoro VA, et al. First-Ever Global Ranking of Palliative Care: 2025 World Map Under the New WHO Framework. J Pain Symptom Manag. 2025;70(5):447\u0026ndash;58.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaylor A, Davies A. Palliative care or supportive care? Clin Med 2025; 100487.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Palliative Care, Health Personnel, Perception, Tertiary Care Centers, Surveys and Questionnaires","lastPublishedDoi":"10.21203/rs.3.rs-9394500/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9394500/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eHealthcare professionals\u0026rsquo; perceptions of palliative care (PC) vary and are shaped by culture, training, and access to resources. This study aimed to identify perceptions and knowledge gaps regarding PC among healthcare professionals in a Brazilian hospital, aligned with the National Humanization Policy of the Unified Health System (SUS). An observational, quantitative study used a questionnaire administered to physicians, nurses, social workers, physical therapists, nutritionists, psychologists, nursing technicians, and other professionals. About one quarter of participants were unaware of the hospital\u0026rsquo;s care services, with significant differences across professions (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Key barriers included prognostic uncertainty, limited conceptual understanding of PC, and concerns about patient and family acceptance, consistent with international reports. Participants agreed that broader professional involvement in end-of-life discussions is needed and that PC services were underused (p\u0026thinsp;=\u0026thinsp;0.003), mainly because of limited access to or adherence to information. Professional training influenced decisions about PC, and confusion persisted regarding the appropriate timing of initiation. Targeted awareness, interprofessional education, and better information flow are required to strengthen implementation and timely access to PC in routine practice across clinical services.\u003c/p\u003e","manuscriptTitle":"Knowledge and Adherence to Palliative Care Practices","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-20 09:50:39","doi":"10.21203/rs.3.rs-9394500/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-05-04T07:22:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-03T23:09:44+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T13:22:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"207624680833729725662992302154728768853","date":"2026-05-01T18:07:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60260689650036851592798744687914291205","date":"2026-05-01T08:34:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"311570239355885294920486473237806148395","date":"2026-04-29T13:58:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"117084961692828146204441256935769093800","date":"2026-04-29T12:44:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"155071964636928837135831716121616048200","date":"2026-04-29T10:44:32+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-13T09:06:15+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-13T07:16:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-13T04:55:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"SN Comprehensive Clinical Medicine","date":"2026-04-12T13:17:04+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"137f2b84-ac31-4b07-b5fa-9a314aacb143","owner":[],"postedDate":"April 20th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Revision requested","date":"2026-05-04T07:22:58+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-03T23:09:44+00:00","index":60,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-02T13:22:33+00:00","index":59,"fulltext":""},{"type":"reviewerAgreed","content":"207624680833729725662992302154728768853","date":"2026-05-01T18:07:23+00:00","index":58,"fulltext":""},{"type":"reviewerAgreed","content":"60260689650036851592798744687914291205","date":"2026-05-01T08:34:36+00:00","index":57,"fulltext":""},{"type":"reviewerAgreed","content":"311570239355885294920486473237806148395","date":"2026-04-29T13:58:04+00:00","index":55,"fulltext":""},{"type":"reviewerAgreed","content":"117084961692828146204441256935769093800","date":"2026-04-29T12:44:45+00:00","index":54,"fulltext":""},{"type":"reviewerAgreed","content":"155071964636928837135831716121616048200","date":"2026-04-29T10:44:32+00:00","index":53,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T07:38:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-20 09:50:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9394500","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9394500","identity":"rs-9394500","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}