Palliative care in the emergency department: An observational study of doctors in KwaZulu-Natal

Background: The World Health Organization advocates the early, appropriate provision of palliative care (PC) to patients throughout the life course. Patient consultations to the emergency department (ED) have been recognised as opportunities to initiate or optimise their PC needs. This study aimed to assess the knowledge of and attitudes towards PC among doctors at emergency physician staffed EDs in KwaZulu-Natal, South Africa. Methods: A cross-sectional survey was conducted between November 2021 and February 2022 for doctors employed out at emergency physician staffed EDs in KwaZulu-Natal, South Africa, using the validated Palliative Care Attitude and Knowledge questionnaire. The variables assessed were the self-rated and basic knowledge and attitudes towards core domains of PC. Ordinal data were compared using the t-test or ANOVA as appropriate, using MedCalc (R) Statistical Software version 22.009. Results: Of the 39 participants, the scores for the knowledge questions showed that 15.3% % participants had good knowledge, 53.8% % had fair knowledge and 30.7% % had poor knowledge. Participants had either favourable (58.8%) % ) or an uncertain (41.0%) % ) attitude towards PC. No correlation was seen between the knowledge and attitudes scores (Spearman's rho = 0.13, 95% % CI -0.19 to 0.43, p = 0.43). Conclusion: There appears to be a deficit in knowledge of PC among doctors in the ED and a need for in-service training in PC for emergency care physicians. Contribution: This study provides new knowledge around PC practices at EDs in KwaZuluNatal, South Africa.