• Barbara A Daveson, Juan P Alonso, Natalia Calanzani, Christina Ramsenthaler, Marjolein Gysels, Barbara Antunes, Katrien Moens, Esther I Groeneveld, Gwenda Albers, Silvia Finetti, Francesca Pettenati, Claudia Bausewein, Irene J Higginson, Richard Harding, Luc Deliens, Franco Toscani, Pedro L Ferreira, Lucas Ceulemans, Barbara Gomes, and PRISMA.
• 1 King's College London, Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, UK.
• Eur J Public Health. 2014 Jun 1; 24 (3): 521-7.

BackgroundDespite ageing populations and increasing cancer deaths, many European countries lack national policies regarding palliative and end-of-life care. The aim of our research was to determine public views regarding end-of-life care in the face of serious illness.MethodsImplementation of a pan-European population-based survey with adults in England, Belgium (Flanders), Germany, Italy, The Netherlands, Portugal and Spain. Three stages of analysis were completed on open-ended question data: (i) inductive analysis to determine a category-code framework; (ii) country-level manifest deductive content analysis; and (iii) thematic analysis to identify cross-country prominent themes.ResultsOf the 9344 respondents, 1543 (17%) answered the open-ended question. Two prominent themes were revealed: (i) a need for improved quality of end-of-life and palliative care, and access to this care for patients and families and (ii) the recognition of the importance of death and dying, the cessation of treatments to extend life unnecessarily and the need for holistic care to include comfort and support.ConclusionsWithin Europe, the public recognizes the importance of death and dying; they are concerned about the prioritization of quantity of life over quality of life; and they call for improved quality of end-of-life and palliative care for patients, especially for elderly patients, and families. To fulfil the urgent need for a policy response and to advance research and care, we suggest four solutions for European palliative and end-of-life care: institute government-led national strategies; protect regional research funding; consider within- and between-country variance; establish standards for training, education and service delivery.© The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association.

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