Palliative care in Italy: problem areas emerging from the literature.

The aim of this study was to review the Italian literature regarding attitudes toward palliative care in cancer patients, as well as cultural, educational and organizational problems in Italy with respect to palliative care services. The Italian literature published in the last ten years on PUBMED was reviewed. Clinical trials were excluded from this analysis, as their focus was beyond the scope of this study. Non-cancer studies were also excluded. Thirty-nine papers were retrieved. Several weaknesses were recognized in the studies, including a lack of knowledge and negative attitudes regarding cancer pain management and the use of alternative treatments. Communication with patients and family was also inadequate. In general, poor organization of palliative care services was also shown. An appropriate place to die was often not guaranteed and was dependent on the availability of local resources. However, the most striking finding was that there were geographical differences in the distribution of palliative care resources. The development of a range of palliative care programs integrating primary territorial care and specialized palliative services may constitute the ideal synthesis to respond to patients' needs.