title: [Palliative care in Lebanon: views of health professionals and relatives].
abstract: BACKGROUND
  The development of palliative care is still in its primitive state in Lebanon and few studies assessed the views of caregivers on the quality of support of their patients and the difficulties they encounter. We evaluate the perspective of caregivers and the relatives in regard to the quality of support to the terminally ill patients.
  
  
  METHODS
  A cross-sectional descriptive, analytic and comparative study is carried out between September and October 2010, among two groups - Group 1: Health professionals from a university hospital in Beirut; Group 2 : Relatives of recently deceased persons following a chronic, incurable disease.
  
  
  RESULTS
  We received 447 responses: 358 in the hospital from caregivers (80%) and 89 in the city from relatives (20%). The management of physical problems of patients at end of life is considered adequate by 68% of caregivers while only 40% believe that psychological problems are managed adequatly. Physical difficulties most often encountered are intractable pain (44%) ; psychological problems frequently noted at this stage are depression (40%), anxiety (18%) and fear of death (115%). Caregivers (69%) and relatives (62%) are in favor of informing the patient about the seriousness of his illness; and physicians more frequently than nurses (75% vs 675%, p = 0.002). Relatives (75%) and caregivers (73%) believe that today in Lebanon, the terminally ill patients do not die in peace and dignity (p = 0.022). 71% of caregivers vs 62% of relatives consider that intensive medications are used in cancer patients (p < 0.001) and non-cancer patients (61% caregivers vs 60% of relatives; p > 0.05).
  
  
  CONCLUSIONS
  The management of terminally ill patients and their families must be improved. Palliative care services adapted to the cultural, social and economic characteristics of the country, and involving the private and public sectors should be integrated into the current health system.
authors.affiliation: Service de Médecine interne, Centre hospitalier universitaire Hôtel-Dieu de France, Université Saint-Joseph, Faculté de Médecine, Beyrouth, Liban. atohme2@inco.com.lb
authors.forename: Aline
authors.initials: A
authors.lastname: Tohmé
authors.affiliation: Service de Médecine interne, Centre hospitalier universitaire Hôtel-Dieu de France, Université Saint-Joseph, Faculté de Médecine, Beyrouth, Liban.
authors.forename: Lama
authors.initials: L
authors.lastname: Abi Khalil
authors.affiliation: Service de Médecine interne, Centre hospitalier universitaire Hôtel-Dieu de France, Université Saint-Joseph, Faculté de Médecine, Beyrouth, Liban.
authors.forename: Zalfa
authors.initials: Z
authors.lastname: Kanaan
mesh_terms: D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005190:Family; D006801:Humans; D007861:Lebanon; D010166:Palliative Care; D010564:Personnel, Hospital; D011787:Quality of Health Care; D011795:Surveys and Questionnaires