Table 2 Barriers to providing end-of-life psychiatric care

A: Patients’ personal problems

1. Accepting reality and physical condition (A5)

14

(6.3)

8

(6.8)

6

(5.7)

2. Lack of emotion expression (A8)

12

(5.4)

6

(5.1)

6

(5.7)

3. Severe depression or suicide ideation (A7)

5

(2.2)

2

(1.7)

3

(2.8)

4. Problems of cognitive function or comprehension (A4)

8

(3.6)

6

(5.1)

2

(1.9)

5. Depression (A2)

8

(3.6)

4

(3.4)

4

(3.8)

6. Refusal of psychiatric care (A6)

7

(3.1)

4

(3.4)

3

(2.8)

7. Anxiety or embarrassment (A1)

5

(2.2)

5

(4.3)

0

(0.0)

8. Problems specific to young adults (A9)

4

(1.8)

3

(2.6)

1

(0.9)

9. Aggression (A3)

3

(1.3)

2

(1.7)

1

(0.9)

B: Family members’ problems

10. Lack of family support (B2)

13

(5.8)

7

(6.0)

6

(5.7)

11. Accepting reality among family members (B1)

13

(5.8)

8

(6.8)

5

(4.7)

12. Differences in opinions or comprehension among family members (B4)

10

(4.5)

9

(7.7)

1

(0.9)

13. Problems of family relationship (B3)

3

(1.3)

1

(0.9)

2

(1.9)

C: Professionals’ personal problems

14. Problems of time and place (C1)

33

(14.8)

18

(15.4)

15

(14.2)

15. Lack of self-confidence in one’s skills in psychiatric care (C2)

20

(9.0)

9

(7.7)

11

(10.4)

16. Problems related to inter-professional team work (C5)

14

(6.3)

8

(6.8)

6

(5.7)

17. Ability differences between health care providers (C4)

9

(4.0)

6

(5.1)

3

(2.8)

18. Psychological burden in health care providers (C3)

3

(1.3)

1

(0.9)

2

(1.9)

D: Communication problems between professionals and patients

19. Lack of trust between professionals and patients (D2)

7

(3.1)

5

(4.3)

2

(1.9)

20. Differences in opinions or comprehension in professionals vs. patients (D1)

4

(1.8)

3

(2.6)

1

(0.9)

E: Challenges specific to end-of-life care

21. Difficulty in providing psychological care to patients who were not disclosed the “bad news” (E5)

10

(4.5)

5

(4.3)

5

(4.7)

22. Difficulty in providing psychological care after disclosure of “bad news” (E4)

10

(4.5)

4

(3.4)

6

(5.7)

23. Circumstances do not meet patients’ expectations (E7)

6

(2.7)

1

(0.9)

5

(4.7)

24. Problems of sudden deterioration of physical condition (E2)

5

(2.2)

2

(1.7)

3

(2.8)

25. Problems of spiritual pain and acceptance of death (E3)

4

(1.8)

2

(1.7)

2

(1.9)

26. Difficulty in providing psychological care to patients who were disclosed the “bad news” at a later time (E6)

2

(0.9)

0

(0.0)

2

(1.9)

27. Problems of physical pain (E1)

2

(0.9)

1

(0.9)

1

(0.9)

F: Challenges specific to psychiatric care

28. Necessity of individual care for each patient (F2)

14

(6.3)

7

(6.0)

7

(6.6)

29. Difficulty of psychiatric assessment and intervention (F1)

7

(3.1)

3

(2.6)

4

(3.8)

30. Lack of robust policy or correct answer (F3)

2

(0.9)

1

(0.9)

1

(0.9)

G: Problems of institution or system

31. Lack of professional team or health care providers (G1)

12

(5.4)

4

(3.4)

8

(7.5)

32. Lack of training system for psychiatric care (G3)

7

(3.1)

1

(0.9)

6

(5.7)

33. Short-handed conditions (G2)

6

(2.7)

5

(4.3)

1

(0.9)

34. Difficulty of compatibility with outpatient service (G4)

5

(2.2)

5

(4.3)

0

(0.0)

35. Difficulty of participating in informed consent (G5)

4

(1.8)

3

(2.6)

1

(0.9)

H: Challenges specific to non-cancer patients

36. Difficulty in evaluating prognostic prediction in non-cancer patients (H2)

10

(4.5)

0

(0.0)

10

(9.4)

37. Lack of practice guidelines for non-cancer patients (H1)

4

(1.8)

0

(0.0)

4

(3.8)

38. Lack of understanding about providing palliative care for non-cancer patients in patients or family members (H3)

3

(1.3)

0

(0.0)

3

(2.8)

39. Lack of experience of health care providers in providing palliative care to non-cancer patients (H4)

4

(1.8)

1

(0.9)

3

(2.8)

40. Lack of a professional team or health care providers who specialize in palliative care for non-cancer patients (H5)

3

(1.3)

0

(0.0)

3

(2.8)