Keywords: family medicine residents, palliative care, coordination of care, primary healthcare, attitudes, Croatia

Background:

Palliative care in Croatia is strategically rooted in primary healthcare, with general practitioners acting as central coordinators and providers of primary palliative care within multidisciplinary teams.

Research questions:

To evaluate and compare the attitudes of family medicine residents regarding the palliative care organizational model in Croatia, specifically focusing on their role as primary coordinators of care.

Method:

A repeated cross-sectional study was conducted among family medicine residents in Croatia at two different time points: in 2023 (n=95) and 2025 (n=122). Data were collected using a survey questionnaire with eight sociodemographic questions and eight statements about residents’ attitudes regarding the existing palliative care system and the feasibility of the coordinator role, measured by five-point Likert scale. Differences between the two cohorts were statistically analysed to identify shifts in perception over the two-year period. P < 0.05 was considered as significant.

Results:

Participants in the 2025 cohort had statistically significantly more clinical experience compared to the 2023 cohort. There was no statistically significant difference in general attitudes toward palliative care between the cohorts. Both groups demonstrated a relatively low overall score on attitudes questionnaire (mean score 26.8 vs. 28.0). The item receiving the lowest rating in both cohorts was the statement: "I am familiar with the National Program for the Development of Palliative Care in Croatia." Notably, this was the only item where the 2025 cohort showed a statistically significant improvement compared to the 2023 cohort, although the absolute score remained low.

Conclusions:

Despite a slight increase in clinical experience in the more recent cohort, attitudes toward the palliative care system among family medicine residents remain suboptimal and stagnant. While the 2025 cohort showed improved awareness of strategic documents, further efforts are needed to integrate palliative care coordination into residency training to better prepare future family physicians for their role as primary provider of care.

Points for discussion:

How to achieve useful education of family medicine residents in matters of palliative care?