Table 2.

Barriers to Early Integration of Palliative Care

Barrier	Respondents Indicating Somewhat/ Extreme Importance (n=424)	Mean Score (SD)*
Lack of home-based services	86%	4.37 (1.11)
Limited access to palliative care specialists or services	85%	4.29 (1.07)
Family resistance to involvement of palliative care	80%	4.10 (1.07)
Limited physician knowledge on the role of palliative care	79%	3.95 (1.05)
Physician discomfort in raising the topic of palliative care with families	72%	3.75 (1.07)
Physician desire to maintain hope	68%	3.73 (1.37)
Uncertainty about patient prognosis	68%	3.72 (1.05)
Time constraints of pediatric oncologists during consultation	61%	3.54 (1.11)
Cost of palliative care consultation and treatment	51%	3.30 (1.48)

^*The 5-point likert scale is assigned numeric value (1=“Extremely Unimportant” and 5=“Extremely Important”); the mean score was calculated for each barrier based on the numeric value assigned by all respondents.