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临床前医学生对慢性病患者和临终患者护理的态度:姑息治疗教学会产生影响吗?

Attitudes of preclinical medical students towards caring for chronically ill and dying patients: does palliative care teaching make a difference?

作者信息

Lloyd-Williams M, Dogra N

机构信息

Department of Primary Care, University of Liverpool Medical School, Liverpool, UK.

出版信息

Postgrad Med J. 2004 Jan;80(939):31-4. doi: 10.1136/pmj.2003.009571.

Abstract

INTRODUCTION

Students entering medical school today will encounter an ageing population and a higher incidence of diseases affecting the elderly-for example, chronic respiratory and cardiac disease and malignancy.

PURPOSE

This study was carried out to determine the attitudes of preclinical medical students towards the care of patients for whom a cure is not possible.

METHODS

All students were invited to complete a 23 item questionnaire prior to initial teaching and again following the second teaching session in palliative care.

RESULTS

Overall, 149 of the 186 students (80%) completed the pre-teaching questionnaire (59 males and 90 females; median age 20 years, range 19-27 years), and 66 students (35%) completed the post-teaching questionnaire. Attitudes towards chronically ill and dying patients were generally positive. It was found that increasing age was associated with a more positive view of caring for patients with chronic or terminal illness, a more positive view of listening to patients reminisce, and a more positive view of patients dying at home (p = 0.014). The only notable result was that after palliative care teaching students had a significantly more positive view of hospices.

CONCLUSION

Caring for patients at the end of life can be one of the most rewarding aspects of being a doctor. This study suggests that the majority of medical students have a positive attitude towards patients with chronic incurable illness, and the trend for encouraging older students to enter medicine may be an influencing factor.

摘要

引言

如今进入医学院的学生将面对老龄化人口以及影响老年人的疾病发病率上升的情况,例如慢性呼吸道疾病、心脏病和恶性肿瘤。

目的

本研究旨在确定临床前医学生对无法治愈患者护理的态度。

方法

所有学生在初始教学前被邀请完成一份包含23个项目的问卷,并在第二次姑息治疗教学课程结束后再次填写。

结果

总体而言,186名学生中有149名(80%)完成了教学前问卷(59名男性和90名女性;年龄中位数20岁,范围19 - 27岁),66名学生(35%)完成了教学后问卷。对慢性病患者和临终患者的态度总体较为积极。研究发现,年龄增长与对慢性病或绝症患者护理的更积极看法、对倾听患者回忆的更积极看法以及对患者在家中死亡的更积极看法相关(p = 0.014)。唯一显著的结果是,在接受姑息治疗教学后,学生对临终关怀机构的看法明显更为积极。

结论

照顾临终患者可能是成为一名医生最有意义的方面之一。这项研究表明,大多数医学生对慢性不治之症患者持积极态度,鼓励年龄较大的学生进入医学领域的趋势可能是一个影响因素。

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本文引用的文献

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An international survey of undergraduate medical education in palliative medicine.
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