Effect of a population-based educational intervention focusing on end-of-life home care, life-prolonging treatment and knowledge about palliative care

The effectiveness of population-based educational interventions in palliative care is unclear. We conducted an educational intervention study for the general public focusing on end-of-life home care, life-prolonging treatment and knowledge about palliative care and measured the change in perception about these issues. Participants were recruited from the 11 districts of Fukushima City, Japan. One-hour educational lectures were conducted in each district from April 2006 to March 2007. Meetings were held in a community centre or hall in each district. We asked participants to fill in a questionnaire before and after the educational lecture. Of 607 participants, 595 (98%) answered both pre- and post-intervention questionnaires. The feasibility of a home death changed from 9% before to 34% after the intervention (P < 0.001). In addition, preference for life-prolonging treatment and attitudes toward end-of-life care including symptom management at home, misconceptions about opioids, artificial hydration and communication issues between patient and medical practitioners were significantly improved after the intervention. Factors that were significantly associated with changing perceptions about the feasibility of a home death were male gender, change in beliefs regarding burden to family caregivers, anxiety regarding admission to the hospital with worsening physical condition and fear that pain would not be relieved at home. This population-based educational intervention was effective in changing beliefs regarding the feasibility of home care, preference for life-prolonging treatment and attitudes toward end-of-life care.