Kolarik Russ C, Walker Gena, Arnold Robert M
Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. kolarikrc@.upmc.edu
Pediatrics. 2006 Jun;117(6):1949-54. doi: 10.1542/peds.2005-1111.
The goal was to characterize pediatric residents' perceived educational needs for pediatric palliative care. The data generated from this study will facilitate the planning of specific educational interventions.
All residents in the Children's Hospital of Pittsburgh pediatrics residency program were asked to complete a survey in September 2003. Participation in the study was voluntary. Residents rated their previous training, personal experience, knowledge, competence, and emotional comfort with 10 specific aspects of pediatric palliative care. This rating was followed by 13 questions related to attitudes about palliative care practices and training. The last section asked the respondents to rank 11 palliative care educational topics in order of importance.
Forty-nine of 75 eligible residents participated. Although residents thought that pediatricians should have an important role in providing palliative care, residents reported minimal training, experience, knowledge, competence, and comfort in virtually all areas of palliative care for children. We found no significant improvement in any of these areas from the pediatric level-1 year to the pediatric level-3 year. Residents wanted more training regarding pain management. After pain control, the next 4 educational needs were communication skills, namely, discussing prognosis, bad news, and code status and talking with children about end-of-life care.
There is a clear need for increased efforts in pediatric palliative care education during residency training. Pediatric residents do not think that they are trained adequately in palliative care, and this perception does not improve with time. Pediatric residents view palliative care as important for primary care physicians and desire more education.
旨在描述儿科住院医师对儿科姑息治疗的感知教育需求。本研究产生的数据将有助于规划具体的教育干预措施。
2003年9月，匹兹堡儿童医院儿科住院医师培训项目的所有住院医师都被要求完成一项调查。参与研究是自愿的。住院医师对他们之前在儿科姑息治疗10个具体方面的培训、个人经验、知识、能力和情感舒适度进行评分。在该评分之后，有13个与姑息治疗实践和培训态度相关的问题。最后一部分要求受访者按重要性顺序对11个姑息治疗教育主题进行排序。
75名符合条件的住院医师中有49名参与。尽管住院医师认为儿科医生在提供姑息治疗方面应发挥重要作用，但他们报告称在儿童姑息治疗几乎所有领域的培训、经验、知识、能力和舒适度都很低。我们发现从儿科1年级到儿科3年级，这些领域均未出现显著改善。住院医师希望获得更多关于疼痛管理的培训。在疼痛控制之后，接下来的4个教育需求是沟通技巧，即讨论预后、坏消息和代码状态，以及与儿童谈论临终关怀。
在住院医师培训期间，显然需要加大儿科姑息治疗教育的力度。儿科住院医师认为他们在姑息治疗方面没有得到充分培训，而且这种认知不会随着时间的推移而改善。儿科住院医师认为姑息治疗对初级保健医生很重要，并希望获得更多教育。
