Palliative care: training needs, developments, difficulties and perspectives

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Abstract
Approximately 3600 copies of a questionnaire on palliative care were sent out towards the end of 1989. Of the 594 returned, 61 % came from nurses, 23% from medical doctors and 16% from others. Fifty-six per cent had already had training in palliative care but 91 % wanted training or additional training, suggesting that instruction is incomplete or inadequate. The selective character of the persons approached and the low response rate prevent the generalization of the findings to all carers and persons concerned with palliative care. Additional training was requested most on pain control, communication, relationships between carers and those cared for, relationships with families and support for family and friends. The majority of the respondents wanted both lectures as theoretical instruction and opportunities for practical training. Meetings with practitioners and seminars and workshops were the preferred teaching methods for theoretical instruction. Fifty-one per cent of the respondents considered that the practice of palliative care had progressed in their region since 1987, and 41 % that there had been practically no progress or that it had regressed. Seventy-two per cent estimated that palliative care is better accepted by the carers and 70% by patients and those around them. Ninety-two per cent felt that the practice of palliative care still encounters difficulties in their region, the commonest causes of the difficulties being lack of knowledge of palliative care by the carers, reticence on the part of the doctors and inadequate training. The developments most desired are palliative care at home, in homes for the aged, and in geriatric and medical services. Priority in such developments should be given to patients with cancer or with AIDS.

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