Assessment of Palliative Care Knowledge Among Bhutanese Doctors in Bhutan: A Cross-Sectional Study.

BACKGROUND AND AIMS: Palliative care is an active, holistic approach to care that aims to improve the quality of life of patients with life-limiting illnesses and their families by alleviating suffering across physical, psychological, social, and spiritual dimensions. Despite its recognized importance, access to palliative care remains inequitable globally, particularly in low- and middle-income countries. In Bhutan, palliative care is a relatively new concept, first introduced in 2018, with ongoing plans to expand services across all 20 districts by 2027. Medical doctors play a pivotal role in the successful implementation and sustainability of palliative care services nationwide. However, their knowledge of palliative care remains largely unassessed. This study, therefore, aimed to assess the level of palliative care knowledge among medical doctors working across Bhutan. METHODS: A cross-sectional study was conducted across all 20 districts of Bhutan. All Bhutanese medical doctors registered with the Bhutan Medical and Health Council were invited to participate. A validated self-administered questionnaire adapted from the Palliative Care Knowledge Questionnaire-Basic (PCKQ-B) was distributed electronically. Data were analyzed using IBM SPSS Statistics (version 23; IBM Corp., Armonk, NY, USA). Knowledge scores above the median were classified as good knowledge. RESULTS: A total of 157 medical doctors participated in the study. The median knowledge score was 14 (IQR: 12.5-16.0), and 63.1% of participants demonstrated good knowledge of palliative care. The majority were male (61.1%), and more than half were working as consultants (51.6%). On multivariable logistic regression, age between 31 and 40 years (aOR: 5.7, 95% CI: 1.3-25.6; p = 0.024) and inclusion of palliative care in the educational curriculum (aOR: 4.3, 95% CI: 1.5-12.3; p = 0.006) were independently associated with good knowledge. CONCLUSION: Medical doctors in Bhutan demonstrated a reasonably good level of palliative care knowledge. Incorporating palliative care into medical curricula and providing targeted training may further strengthen knowledge and support the sustainable expansion of palliative care services nationwide.