title: A comparative study to assess the awareness of palliative care between urban and rural areas of ernakulum district, kerala, India.
abstract: OBJECTIVE
  To assess the knowledge and attitude toward palliative care among people residing in urban and rural areas.
  
  
  METHODS
  This cross-sectional study was conducted among 185 urban and 165 rural households. Senior-most member of the household present was interviewed using a questionnaire. Only those people who have heard about palliative care were included in the study.
  
  
  RESULTS
  Out of 350 people, 47 (13.4%) have heard about palliative care. Of these 38 (20.5%) belonged to urban and 9 (5.4%) belonged to rural areas (P < 0.0001).Twenty-nine (15.7%) participants in urban and 7 (4.2%) in rural areas had some knowledge about palliative care (P = 0.0002). Source of information for 25 (53.2%) participants was newspapers followed by television 17 (36.2%). Thirty-three (86.8%) participants in urban and 7 (77.8%) in rural areas felt that palliative care helps in improving quality of life. Twenty (52.6%) participants in urban and 4 (44.4%) participants in rural areas felt that palliative care can be better provided at homes than hospitals. Thirty (78.9%) urban participants felt that bad news about the patient's condition needs to be told to the patient first and then to their family members. In case of rural participants majority 7 (77.8%) said vice versa (P = 0.0039).
  
  
  CONCLUSIONS
  Overall awareness of palliative care was poor. This calls for large-scale awareness campaigns. As home-based palliative care was preferred by many, home visits by care providers and training of family members of patient's needing palliative care needs to be practiced widely.
authors.affiliation: Department of Community Medicine, Kasturba Medical College, Mangalore, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Joseph
authors.forename: Jayarama
authors.initials: J
authors.lastname: S
authors.forename: Shashidhar
authors.initials: S
authors.lastname: Kotian