Physicians’ knowledge, attitudes and practices on advance care planning for patients with advanced cancer in a National University Hospital in the Philippines

Abstract

Purpose: Advance care planning (ACP) is generally part of patients’ rights and decision-making processes. It is a component of the patient–physician care dynamics, especially in the context of life-threatening illness. Little is known about ACP and the utilisation of advance directives in the Philippines, a country of 110 million people. The study aimed to explore the knowledge, attitudes and practices (KAPs) of resident physicians in a national university hospital in the Philippines regarding ACP for patients with advanced cancer. Methods: Using a cross-sectional design involving resident physicians, an online survey with a self-administered questionnaire was distributed and answered by a total of 202 respondents. Results: Results show that resident physicians generally: (1) view palliative and hospice medicine to be the same and without differences, (2) are comfortable with discussing ACP and prognosis of medical conditions with patients and their families, but (3) do not regularly initiate or offer ACP to them, (4) identify a lack of time, fear of imparting emotional distress to patients and their families and personal discomfort as barriers to conducting ACP and (5) have had no formal training for ACP but are willing to undergo such formation, given the opportunity. Conclusion: This study highlights the continuing need to bridge and unite KAPs pertaining to ACP among physicians. Further studies should be undertaken to device a proper training program and better explore the complexities of end-of-life care as it is experienced by Filipino patients with advanced cancer.