title: What influences the willingness of community physicians to provide palliative care for patients with terminal cancer? Evidence from a nationwide survey.
abstract: OBJECTIVE
  Community physicians have a vital role in delivering palliative care, yet their willingness and factors that influence its provision have rarely been explored. Our aims were to identify the willingness of community physicians to provide palliative care for patients with terminal cancer and to investigate the factors that influence their willingness to provide such care.
  
  
  METHODS
  Through a structured questionnaire, this nationwide study surveyed 708 community physicians who were potential pilots to provide palliative care. Four hundred and ten valid questionnaires (58.0%) were retrieved and analysed.
  
  
  RESULTS
  The majority of respondents expressed a willingness (92.4%) to provide palliative care if they encountered patients with terminal cancer. However, they would limit their services to consultation (83.4%) and referral (86.8%), and were less likely to see patients and prescribe medicine (62.0%), to provide phone follow-ups (45.6%), to provide home visits (42.2%) or to offer bereavement care for the family (35.1%). The results of stepwise logistic regression analysis for the willingness to provide home visits showed that 'less perception of barriers', 'family medicine specialist' and 'older than 50 years' significantly predicted higher willingness, while 'female' predicted lower willingness. There was no significant association between the willingness and the knowledge score.
  
  
  CONCLUSIONS
  Community physicians' beliefs and experience in palliative care rather than their knowledge influence their willingness to provide palliative care for patients with terminal cancer. Only through active participation in the real-world clinical setting and active health policy administration can community physicians overcome obstacles to providing palliative care.
authors.affiliation: Department of Community and Family Medicine, National Taiwan University Hospital Yun-Lin Branch, No. 579 Sec. 2 Yunlin Road, Douliou City, Yunlin, Taiwan.
authors.forename: Jen-Kuei
authors.initials: JK
authors.lastname: Peng
authors.forename: Tai-Yuan
authors.initials: TY
authors.lastname: Chiu
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Hu
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Shou-Hung
authors.initials: SH
authors.lastname: Hung
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003154:Community Medicine; D003695:Delivery of Health Care; D005260:Female; D006792:House Calls; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care; D010820:Physicians / Q000523:psychology*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D013624:Taiwan; D013727:Terminal Care