title: Hospice care in Calgary: Survey of family physicians on their knowledge, experience, and attitudes.
abstract: OBJECTIVE
  To explore Calgary family physicians' knowledge about hospices, their attitudes toward the referral process, and their understanding of barriers to referral for hospice care.
  
  
  METHODS
  Surveys were mailed to 400 randomly selected participants. The survey contained 18 questions related to hospice care, physician experience, attitudes, and perceived barriers to making a hospice referral.
  
  
  METHODS
  Calgary, Alta.
  
  
  METHODS
  Family physicians.
  
  
  METHODS
  Survey responses were analyzed quantitatively using the (2) goodness-of-fit test, Kruskal-Wallis tests, and logistic regression analyses to examine univariate associations. Qualitative analysis of open-ended questions was done by content analysis and thematic coding.
  
  
  RESULTS
  In total, 104 surveys were mailed back. Family physicians agreed that palliative care in a hospice setting can greatly improve quality of life for patients, but only 2 of 6 knowledge questions about hospice care were answered correctly by most. Family physicians with special areas of interest or subspecialties were more likely to feel well-informed about hospice referrals (P = .017), indicated a higher comfort level discussing hospice and palliative care (P = .030), and were less likely to defer discussing it with patients (P = .023). Physicians with a special interest in palliative medicine were more likely to correctly answer the knowledge questions (P < .034) and to be familiar with the referral process (P < .001), patient eligibility (P < .001), and the palliative home care program (P = .003). Qualitative analysis revealed support for palliative home care and consultation services but concerns about caregiver coping and family issues. Concerns about disengagement of family physicians and uncertainty about the referral process are obstacles to referral.
  
  
  CONCLUSIONS
  While Calgary family physicians are appreciative of hospice care, there are knowledge gaps. It is important to engage family physicians in the referral process.
authors: Assistant Professor in the Department of Family Medicine at the University of Calgary in Alberta. rnspice@ucalgary.ca.
authors: Ronald
authors: R
authors: Spice
authors: Family physician practising in Calgary.
authors: Monica
authors: M
authors: Lau
authors: Research coordinator, Department of Family Medicine at the University of Calgary.
authors: Grace
authors: G
authors: Perez
authors: Research coordinator, Department of Family Medicine at the University of Calgary.
authors: Nathan
authors: N
authors: Turley
authors: Research Director, Department of Family Medicine at the University of Calgary.
authors: Tanvir Chowdhury
authors: TC
authors: Turin
mesh_terms: D000328:Adult; D000416:Alberta; D007722:Health Knowledge, Attitudes, Practice; D006699:Home Care Services / Q000592:standards*; D017051:Hospice Care / Q000592:standards*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010166:Palliative Care / Q000592:standards*; D010821:Physicians, Family / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011788:Quality of Life; D012017:Referral and Consultation; D011795:Surveys and Questionnaires