title: Underlying barriers to referral to paediatric palliative care services: knowledge and attitudes of health care professionals in a paediatric tertiary care centre in the United Kingdom.
abstract: Referrals to children's palliative care services typically occur late in the illness trajectory, with many children who would benefit not referred at all. Previous studies report health care professionals' (HCPs) assessment of various parent-related factors as barriers to referral. We conducted a cross-sectional survey of HCPs working in a paediatric tertiary care hospital in the United Kingdom, with an established paediatric palliative care team, to explore staff perceptions of barriers, knowledge and attitudes, with the aim of developing interventions to increase patient access to palliative care services. Survey respondents evidenced good knowledge of the principles of palliative care in closed questions, but their attitudes expressed in open-text questions and reported reasons to refer to a palliative care service demonstrated an association of palliative care with death and dying. We suggest that the association of palliative care with end of life may be a modifiable factor relevant to late and non-referral and deserving of further investigation and attention in education and training.
authors.affiliation: Louis Dundas Centre for Children's Palliative Care, UCL Institute of Child Health, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Twamley
authors.forename: Finella
authors.initials: F
authors.lastname: Craig
authors.forename: Paula
authors.initials: P
authors.lastname: Kelly
authors.forename: Delia R
authors.initials: DR
authors.lastname: Hollowell
authors.forename: Patricia
authors.initials: P
authors.lastname: Mendoza
authors.forename: Myra
authors.initials: M
authors.lastname: Bluebond-Langner
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000523:psychology* / Q000706:statistics & numerical data*; D010290:Parents; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D062606:Tertiary Care Centers; D006113:United Kingdom
keywords: Attitudes; paediatric; palliative care; survey design