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与患者谈论死亡和临终事宜。

Talking to patients about death and dying.

作者信息

Burgess Teresa A, Brooksbank Mary, Beilby Justin J

机构信息

Evaluation Unit, Department of General Practice, University of Adelaide, South Australia.

出版信息

Aust Fam Physician. 2004 Jan-Feb;33(1-2):85-6.

Abstract

INTRODUCTION

Talking about death and dying, either with patients terminally ill or well, presents challenges for the general practitioner. There are few Australian educational resources and little Australian research into this area.

METHODS

We undertook two focus groups, an interview process, and a final consultation with palliative care experts and GPs.

RESULTS

General practitioners felt they needed support and education in talking about death and dying. This is separate from discussions about 'Advanced Health Care Directives'. General practitioners were open to learning new ways to help patients and families approach dying, but require support and education around initiating discussions, asking the right questions and accessing services. Participating GPs emphasised the importance of utilising palliative care supports and resources to provide ongoing spiritual and physical care. Many were particularly concerned with access to support for dying patients for both indigenous patients and those from other cultures. Advance Health Care Directives were regarded by participating GPs to be tools to facilitate a discussion around death and dying, rather than their primary purpose.

DISCUSSION

We developed a booklet to provide practical, useful guidelines for GPs in their daily practice.

摘要

引言

无论是与绝症患者还是健康患者谈论死亡,对全科医生来说都是一项挑战。澳大利亚在这方面的教育资源稀缺,相关研究也很少。

方法

我们开展了两个焦点小组、一个访谈过程,并与姑息治疗专家和全科医生进行了最后咨询。

结果

全科医生觉得他们在谈论死亡时需要支持和教育。这与关于“高级医疗保健指令”的讨论是分开的。全科医生愿意学习帮助患者及其家人面对死亡的新方法,但在发起讨论、提出恰当问题以及获取服务方面需要支持和教育。参与的全科医生强调了利用姑息治疗支持和资源提供持续精神和身体护理的重要性。许多人特别关注为原住民患者和其他文化背景的患者提供临终支持。参与的全科医生认为高级医疗保健指令是促进围绕死亡进行讨论的工具,而非其主要目的。

讨论

我们编写了一本手册,为全科医生在日常实践中提供实用、有用的指南。

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