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英国一家国民保健服务医院的资深临床医生的信仰体系概况及对临终决策的态度

A profile of the belief system and attitudes to end-of-life decisions of senior clinicians working in a National Health Service Hospital in the United Kingdom.

作者信息

Pugh E J, Song R, Whittaker V, Blenkinsopp J

机构信息

University of Teesside, North Tees and Hartlepool Foundation Trust, Stockton on Tees.

出版信息

Palliat Med. 2009 Mar;23(2):158-64. doi: 10.1177/0269216308100248. Epub 2008 Dec 10.

Abstract

There is evidence from outside the United Kingdom to show that physicians' religious beliefs influence their decision making at the end of life. This UK study explores the belief system of consultants, nurse key workers and specialist registrars and their attitudes to decisions which commonly must be taken when caring for individuals who are dying. All consultants (N = 119), nurse key workers (N = 36) and specialist registrars (N = 44) working in an acute hospital in the north-east of England were asked to complete a postal questionnaire. In all, 65% of consultants, 67% of nurse key workers and 41% of specialist registrars responded. Results showed that consultants' religion and belief systems differed from those of nurses and the population they served. Consultants and nurses had statistically significant differences in their attitudes to common end of life decisions with consultants more likely to continue hydration and not withdraw treatment. Nurses were more sympathetic to the idea of physician-assisted suicide for unbearable suffering. This study shows the variability in belief system and attitudes to end of life decision making both within and between clinical groups. This may have practical implications for the clinical care given and the place of care. The personal belief system of consultants was not shown to affect their overall attitudes to withdrawing life-sustaining treatment or physician-assisted suicide.

摘要

来自英国以外地区的证据表明,医生的宗教信仰会影响他们在临终时的决策。这项英国研究探讨了会诊医生、护士关键岗位工作人员和专科住院医生的信仰体系,以及他们对在照顾临终患者时通常必须做出的决策的态度。在英格兰东北部一家急症医院工作的所有会诊医生(N = 119)、护士关键岗位工作人员(N = 36)和专科住院医生(N = 44)都被要求填写一份邮寄问卷。总共65%的会诊医生、67%的护士关键岗位工作人员和41%的专科住院医生做出了回应。结果显示,会诊医生的宗教和信仰体系与护士及其所服务的人群不同。会诊医生和护士在对常见临终决策的态度上存在统计学上的显著差异,会诊医生更倾向于继续补液且不停止治疗。护士对于因无法忍受的痛苦而实施医生协助自杀的想法更为同情。这项研究表明,临床群体内部以及不同临床群体之间在信仰体系和对临终决策的态度上存在差异。这可能对所提供的临床护理和护理场所产生实际影响。会诊医生的个人信仰体系并未显示会影响他们对停止维持生命治疗或医生协助自杀的总体态度。

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