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正在学习照料濒死患者的实习生。

Interns learning to care for dying patients.

作者信息

Rhodes-Kropf Jennifer, Meier Diane, Adelman Ronald

机构信息

Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Division of Geriatrics, Bronx, New York 10467-2490, USA.

出版信息

J Palliat Med. 2003 Dec;6(6):865-72. doi: 10.1089/109662103322654749.

Abstract

OBJECTIVE

To examine interns' perceptions of the emotional support they were able to provide to dying patients and their families, as well as their evaluation of attending physicians as role models caring for dying patients and their families.

METHODS

A semistructured, face-to-face interview of a convenience sample of 38 internal medicine interns in two New York City teaching hospitals who were the primary house officers of patients dying between January 2000 and April 2000.

RESULTS

Fifty-eight percent of interns rated their comfort level in talking to their patient and family about end-of-life issues as good to excellent. Sixty percent of interns estimated that their impact on their patient's emotional experiences as they approached death as none to minimal. Seventy-four percent of interns rated their patient's physical comfort level good to excellent. Interns rated attending physicians as effective role models in 66% of cases; 34% percent were rated as poor to mediocre. Observation of attending physicians with patients and families was rated as the most effective method to learn how to care for dying patients.

CONCLUSIONS

While most interns felt comfortable speaking to their patients and their families about end-of-life issues, they also believed that they provided only minimal emotional support. Interns believe that direct observation of attending physicians is the most effective way to improve their skills caring for dying patients and their families; however, they report wide variability in attending physician performance as role models.

摘要

目的

探讨实习生对他们能够为临终患者及其家属提供的情感支持的看法,以及他们对主治医生作为照顾临终患者及其家属的榜样的评价。

方法

对纽约市两家教学医院的38名内科实习生进行了半结构化的面对面访谈,这些实习生是2000年1月至2000年4月期间临终患者的主要住院医生。

结果

58%的实习生认为他们在与患者及其家属谈论临终问题时的舒适度为良好至优秀。60%的实习生估计他们对患者临终时情感体验的影响为无至极小。74%的实习生认为他们患者的身体舒适度为良好至优秀。66%的案例中,实习生将主治医生评为有效的榜样;34%被评为差至中等。观察主治医生与患者及其家属的互动被评为学习如何照顾临终患者的最有效方法。

结论

虽然大多数实习生在与患者及其家属谈论临终问题时感到自在,但他们也认为自己只提供了极少的情感支持。实习生认为直接观察主治医生是提高他们照顾临终患者及其家属技能的最有效方法;然而,他们报告称主治医生作为榜样的表现存在很大差异。

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