Alvarez Marta Pelayo, Agra Yolanda
Primary Health Care Centre, Algemesí, Valencia, Spain.
Palliat Med. 2006 Oct;20(7):673-83. doi: 10.1177/0269216306071794.
A literature review of educational interventions in palliative care (PC) for primary care physicians (PCP) was performed, to evaluate its impact in changing professional practice.
Studies undertaking any educational intervention in PC by PCP, published between 1966 and February 2005, identified through Medline, EMBASE, Cochrane Database of Systematic Reviews and Clinical Trials, Educational Resources Information Centre, Research and Development Resource Base in Continuing Medical Education, Spanish Medical Index, using a combined text word and MESH heading search strategy.
Eighteen articles were included with 1653 physicians. Educative methods were: role model training, small group discussions, and distribution of guidelines. Quality of the studies was low. Opioids prescription improved in two studies. Discrepancies were shown between the perception of PCP in symptom management, determined through questionnaires, and the data concerning opioids prescription. Knowledge improved in all studies. Some benefit of multifaceted approach was stated. Carers were satisfied, in general, with the PCP care, but dissatisfied with patients' pain control.
PC education for PCP is poorly studied. Adequate research designs are necessary in future studies with objective outcomes and patient opinion.
对基层医疗医生姑息治疗（PC）教育干预措施进行文献综述，以评估其对改变专业实践的影响。
通过Medline、EMBASE、Cochrane系统评价数据库和临床试验、教育资源信息中心、继续医学教育研究与发展资源库、西班牙医学索引，采用文本词和医学主题词联合检索策略，检索1966年至2005年2月间发表的基层医疗医生在PC领域进行任何教育干预的研究。
纳入18篇文章，涉及1653名医生。教育方法包括：榜样培训、小组讨论和指南分发。研究质量较低。两项研究中阿片类药物处方有所改善。通过问卷调查确定的基层医疗医生在症状管理方面的认知与阿片类药物处方数据之间存在差异。所有研究中知识均有所提高。提到了多方面方法的一些益处。护理人员总体上对基层医疗医生的护理感到满意，但对患者的疼痛控制不满意。
对基层医疗医生的PC教育研究不足。未来研究需要有充分的研究设计，得出客观结果并征求患者意见。
