Background:

Palliative care access remains limited in Lebanon, particularly outside the capital. Data on public palliative care knowledge and perceptions in general and among disadvantaged populations remain insufficient.

Objective:

This study aimed to assess palliative care awareness and knowledge among community users of a non-governmental organization serving socioeconomically disadvantaged populations in Tripoli, north of Lebanon.

Methods:

A cross-sectional study was conducted using a structured survey targeting 400 individuals using the Palliative Care Knowledge Scale (PaCKS) in the colloquial Arabic language. Data on palliative care awareness and background information were collected. Multivariable binary logistic regression using stepwise backward selection was conducted to identify predictors associated with palliative care knowledge levels and common misconceptions.

Results:

Low awareness of palliative care was observed, with 95.8% of participants reporting never having heard of it. PaCKS’s mean score was 9.24 ± 2.89; 40.8% (N = 163) had high scores (11–13), 42.8% (N = 171) had moderate scores (7–10), and 16.5% (N = 66) had low scores (0–6). Common misconceptions included perceiving palliative care to be limited to hospital care, to cancer, and to end of life. Higher educational attainment was a strong and stable predictor of palliative care knowledge and common misconceptions. Participants with middle or high school education had 1.754 higher odds (p = 0.013), and those with university education had 4.938 higher odds (p < 0.001) for higher knowledge compared to participants with no or primary education, potentially indicating a graded association. More than half of the participants expressed interest in having information about palliative care made generally available.

Conclusion:

Our results indicate low awareness and several misconceptions about palliative care along with the presence of health inequities. Low educational attainment, mainly linked to socioeconomic disadvantage, may limit health literacy, and as such, reduce access to information and the ability to understand complex concepts such as palliative care. These findings highlight the urgent need for a collaborative, multi-sectoral system-thinking, community-centered, and equity-driven approach that involves the community, researchers, healthcare providers, and policymakers.

Plain language summary

Awareness and knowledge of palliative care in Tripoli, Lebanon: Insights from disadvantaged communities

Why was this study done?

In Lebanon, people have limited access to palliative care services. There is insufficient information on the knowledge and awareness of palliative care among laypeople including disadvantaged communities.

We conducted this study to understand how much people using the services of a non-governmental organization in Tripoli, north of Lebanon, know about palliative care and what common misconceptions they have.

What did the researchers do?

We administered a survey in the colloquial Arabic language by trained interviewers. We looked at the knowledge scores and examined whether information such as education, age, gender, and others influence the level of knowledge of participants.

What did the researchers find?

Our study found that most participants never heard of palliative care before. Although they had good palliative care knowledge, almost half of them thought that palliative care is limited to hospitals, cancer, and end of life.

Participants who had no school education or completed primary education were more likely to have lower knowledge and more misconceptions about palliative care compared to those who completed high school or university education.

Participants were interested in knowing about palliative care even in the absence of a serious illness.

What do the findings mean?

Our findings indicate that participants have limited awareness and several misconceptions about palliative care, especially among those who have lower education, making them less likely to access correct information and palliative care services when they need it.

Interventions should focus on engaging communities as equal partners to improve palliative care awareness and access, with collaboration between researchers, healthcare professionals, and policymakers.