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. 2020 Dec 11;1(1):314-320.
doi: 10.1089/pmr.2020.0090. eCollection 2020.

Physicians in Myanmar Provide Palliative Care Despite Limited Training and Low Confidence in Their Abilities

Emily Earl-Royal  1 , Michelle Feltes  1 , Michael A Gisondi  2 , Loretta Matheson  1 , Maung Ohn Tony Htoo  3 , Rebecca Walker  1
Affiliations

Physicians in Myanmar Provide Palliative Care Despite Limited Training and Low Confidence in Their Abilities

Emily Earl-Royal et al. Palliat Med Rep. .

Abstract

Background: Patients in low-income and middle-income countries (LMICs) have limited access to palliative care providers. In Myanmar, little is known about physician knowledge of or perceptions about palliative care. An assessment of physician practice and capacity to provide palliative care is needed. Objective: Our objective was to identify physician practice patterns, knowledge gaps, and confidence in providing palliative and end-of-life care in Myanmar. Design: This was a cross-sectional survey study. Setting/Subjects: Participants were physicians practicing in Myanmar who attended the Myanmar Emergency Medicine Updates Symposium on November 10 to 11, 2018 in Yangon, Myanmar (n = 89). Measurements: The survey used modified Likert scales to explore four aspects of palliative care practice and training: frequency of patient encounters, confidence in skills, previous training, and perceived importance of formal training. Results: Study participants were young (median age 27 years old); 89% cared for terminally ill patients monthly, yet 94% reported less than two weeks of training in common palliative care domains. Lack of training significantly correlated with lack of confidence in providing care. Priorities for improving palliative care services in Myanmar include better provider training and medication access. Conclusions: Despite limited training and low confidence in providing palliative care, physicians in Myanmar are treating patients with palliative needs on a monthly basis. Future palliative care education and advocacy in Myanmar and other LMICs could focus on physician training to improve end-of-life care, increase physician confidence, and reduce barriers to medication access.

Keywords: Myanmar; barriers; confidence; education; low-income and middle-income countries; training.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Frequency of treating patients with palliative care.
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FIG. 2.
Level of confidence the participants feel in each area.
FIG. 3.
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Level of training the participants have received in each area.
FIG. 4.
FIG. 4.
Level of importance the participants assign to receiving training in each area.
FIG. 5.
FIG. 5.
Top priorities for improving palliative care in Myanmar.
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