Palliative care knowledge among medical students

Nobre, Maria Luisa Ribeiro Brant; Lira, Débora Ribeiro de; Brito, Sammantha Maryanne Soares; Rossi-Barbosa, Luiza Augusta Rosa

doi:10.1590/1983-803420243631EN

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Research • Rev. Bioét. 32 • 2024 • https://doi.org/10.1590/1983-803420243631EN copy

Palliative care knowledge among medical students

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of the study was to assess the knowledge of palliative care among medical students at three institutions in northern Minas Gerais. This is a cross-sectional, descriptive study carried out with 320 students from the 1st, 6th and 11th terms, using a survey instrument on philosophy, pain, dyspnea, psychiatric problems, gastric problems and communication. The results were evaluated by the mean percentage of correct answers, with unsatisfactory answers being up to 50%, acceptable between 51% and 70%, desirable between 71% and 80%, and excellent above 80%. The number of correct answers grew as the terms progressed, but with unsatisfactory or acceptable means. Although the students in the 11th term had completed all of the course’s theory, their mean scores were inadequate. These results highlight the need to implement the provisions of CNE/CES Resolution 3/2022 of the National Education Council in undergraduate medical courses to encourage assertive behavior in palliative care.

Keywords
Palliative care; Knowledge; Students, medical

Specific knowledge	Correct answer	No. of correct answers	% of correct answers
*Philosophy*
1. Palliative care should only be provided to patients who do not have access to curative care.	F	241	75.3
2. Palliative care should not be provided alongside cancer treatments.	F	285	89.1
*Pain*
1. When opioids are taken regularly, anti-inflammatories and steroids should not be used.	F	150	46.9
2. Long-term opioid use can often lead to dependence.	F	15	4.7
3. Opioid use has no influence on survival time.	T	67	20.9
4. When a cancer patient experiences pain, opioids should be administered first.	F	133	41.6
5. Some antidepressant and antiseizure drugs help relieve cancer pain.	T	198	61.9
6. The use of laxatives is effective in preventing opioid-induced constipation.	T	85	26.6
7. Opioid dosage increases should be limited because respiratory depression may occur as a side effect.	F	18	5.6
*Dyspnea*
1. Morphine should be used to relieve dyspnea in cancer patients.	T	49	15.3
2. Oxygen saturation levels are correlated with dyspnea.	F	25	7.8
3. Anticholinergic medications or scopolamine hydrobromide are effective for relieving bronchial secretions.	T	89	27.8
4. If the ambient temperature is kept higher (warm), patients with dyspnea often experience relief.	F	53	16.6
*Psychiatric problems*
1. Benzodiazepines should be effective for delirium.	F	94	29.4
2. Some terminally ill patients will require continuous sedation to alleviate suffering.	T	205	64.1
3. Morphine is often a cause of delirium in terminal or cancer patients.	F	55	17.2
4. Delirium often occurs in patients who are prone to mental symptoms.	F	80	25.0
*Gastrointestinal problems*
1. Higher caloric intake is required in terminal stages of cancer compared to initial stages.	F	74	23.1
2. Steroids should improve the appetite of patients with advanced cancer.	T	38	11.9
3. Intravenous infusion will not be effective in relieving dry mouth in terminal patients.	T	55	17.2
*Communication*
1. Good communication between physician and patient can be learned and improved.	T	312	97.5
2. Information requested by patients and relatives and the extent to which patients and relatives participate in decision-making may change according to the course of the illness and condition.	T	288	90.0
3. Uncertain information should not be given to the patient or family as it may cause additional anxiety.	F	79	21.6

Domains	1st term	6th term	11th term
Philosophy	75.5% (desirable)	87.1% (excellent)	86.3% (excellent)
Pain	9.5% (unsatisfactory)	37.3% (unsatisfactory)	53.7% (acceptable)
Dyspnea	5.9% (unsatisfactory)	16.9% (unsatisfactory)	36.6% (unsatisfactory)
Psychiatric problems	16.0% (unsatisfactory)	43.1% (unsatisfactory)	51.3% (acceptable)
Gastrointestinal problems	11.9% (unsatisfactory)	18.8% (unsatisfactory)	23.2% (unsatisfactory)
Communication	66.9% (acceptable)	72.4% (acceptable)	70.3% (acceptable)

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E-mail: bioetica@portalmedico.org.br

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[1] Corresponding author
Maria Luisa Ribeiro Brant Nobre – Av. Cônego Marcos, 411-A, Cintra CEP 39400-385. Montes Claros/MG, Brasil.