Assessing Paramedics' Competence and Training in End-of-Life Care: A Cross-Sectional Study in Saudi Arabia

Background: End-of-life (EOL) care is an integral part of paramedic services, requiring not only medical expertise but also communication skills and emotional support. With the evolving role of paramedics in providing palliative care, understanding their attitudes toward EOL care and the impact of specialized training becomes crucial. Aim: This study aims to assess the attitudes of Saudi Arabian paramedics toward EOL care and evaluate the influence of prior EOL care training on these attitudes. Methods: A cross-sectional study was conducted among paramedics in Saudi Arabia using convenience and snowball sampling. Data were collected via an online survey distributed through emails and social networks, encompassing demographic information and attitudes toward EOL care. The survey was structured into two parts, with the second part developed from the relevant literature. Statistical analysis was performed using STATA version 18, employing chi-squared and Fischer exact tests for comparison. Results: The study involved 1049 paramedics, with the majority being aged 26-35 years (54.43%) and predominantly male (65.59%). About half of the participants (50.43%) had previously participated in EOL care courses. Paramedics who received EOL training demonstrated significantly more positive attitudes toward the role of EOL care in their jobs (98.49% versus 32.12%, p < 0.001) and were more comfortable discussing death with patients (51.42% versus 29.23%, p < 0.001). A significant majority viewed caring for a dying patient as a worthwhile experience (95.42%), and 95.33% agreed on the importance of involving the patient's family in care. Conclusions: The findings highlight the positive impact of EOL care training on paramedics' attitudes toward palliative care. Specialized training enhances paramedics' comfort in discussing death and their perceptions of the role of EOL care, underscoring the need for integrating comprehensive palliative care education into paramedic training programs. Future research should focus on developing standardized EOL care courses to further explore their impact on paramedics' knowledge, attitudes, and practices.