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Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study

McIlfatrick, Sonja; Slater, Paul; Beck, Esther; Bamidele, Olufikayo; McCloskey, Sharon; Carr, Karen; Muldrew, Deborah; Hanna-Trainor, Lisa; Hasson, Felicity


Sonja McIlfatrick

Paul Slater

Esther Beck

Sharon McCloskey

Karen Carr

Deborah Muldrew

Lisa Hanna-Trainor

Felicity Hasson


Background: Palliative care is recognised as a public health issue with the need for earlier integration in the wider healthcare system. However, research indicates that it continues to be accessed late in the course of an illness, public understanding of palliative care is limited, and common misconceptions prevail. Strategies to address this are needed in order to reduce barriers to palliative care delivery and improve access. Methods: An explanatory sequential mixed methods study, comprising a cross-sectional survey and interviews was undertaken. Sociodemographic characteristics, public awareness, knowledge and perceptions of palliative care were examined and strategies to raise awareness and overcome barriers within a public health framework were identified. Survey data were analysed using SPSS v25 with factor analysis and non-parametric statistics and qualitative data were analysed using thematic analysis. Results: A total of 1201 participants completed the survey (58.3% female, mean age 61 years) and 25 took part in interviews. A fifth of participants (20.1%) had previously heard about palliative care and had an accurate understanding of the term. Being female, higher educated, married, and older, increased respondents’ levels of awareness. The three most commonly held misconceptions included: Palliative care is exclusively for people who are in the last 6 months of life (55.4% answered incorrectly); A goal of palliative care is to address any psychological issues brought up by serious illness (42.2% answered incorrectly); and a goal of palliative care is to improve a person’s ability to participate in daily activities (39.6% answered incorrectly). Talking about palliative and end of life care was advocated but societal taboos restricted this occurring with exposure limited to personal experience. Conclusions: Current knowledge gaps and misconceptions derived from limited ad hoc personal experiences and fear of engaging in taboo conversations may deter people from accessing integrated palliative care services early in a disease trajectory. The results indicate the need for public education programmes that move beyond merely raising awareness but provide key messages within a public health approach, which may change attitudes to palliative care thus ultimately improving end of life outcomes.


McIlfatrick, S., Slater, P., Beck, E., Bamidele, O., McCloskey, S., Carr, K., …Hasson, F. (2021). Examining public knowledge, attitudes and perceptions towards palliative care: a mixed method sequential study. BMC Palliative Care, 20(1), Article 44.

Journal Article Type Article
Acceptance Date Feb 14, 2021
Online Publication Date Mar 17, 2021
Publication Date 2021-12
Deposit Date Mar 22, 2021
Publicly Available Date Oct 27, 2022
Journal BMC Palliative Care
Print ISSN 1472-684X
Electronic ISSN 1472-684X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 20
Issue 1
Article Number 44
Keywords Palliative care; Knowledge; Attitudes; Public; Public health; Mixed methods; Health promotion
Public URL


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Copyright Statement
© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,<br /> which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give<br /> appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if<br /> changes were made. The images or other third party material in this article are included in the article's Creative Commons<br /> licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons<br /> licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain<br /> permission directly from the copyright holder. To view a copy of this licence, visit<br /> The Creative Commons Public Domain Dedication waiver ( applies to the<br /> data made available in this article, unless otherwise stated in a credit line to the data.

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