Michelson Kelly Nicole, Ryan Anne Daley, Jovanovic Borko, Frader Joel
Division of Pediatric Critical Care Medicine, Children's Memorial Hospital, Chicago, Illinois 60614-3394, USA.
J Palliat Med. 2009 May;12(5):451-7. doi: 10.1089/jpm.2008.0263.
The American Academy of Pediatrics recommends that pediatricians become knowledgeable in and comfortable with providing palliative care.
The study goals included: determining the extent of training, knowledge, experience, comfort and competence in palliative care communication and symptom management of pediatric residents and fellows; obtaining residents' and fellows' views on key palliative care concepts; identifying topics and methods for palliative care education; and identifying differences in responses between residents and fellows.
DESIGN/METHODS: In academic year 2006-2007 pediatrics residents and fellows completed a survey on: training, experience, knowledge, competence, and comfort in delivering palliative care; palliative care practices; and suggestions for delivering palliative care education.
Fifty-two (60%) and 44 (62%) residents and fellows respectively completed the survey. Residents and fellows described none to moderate levels of training, experience, knowledge, competence and comfort in palliative care. Most respondents said they would benefit from more formal palliative care training. Respondents identified discussing prognosis, delivering bad news, and pain control as the three most important areas of needed education. Learning about supporting families spiritually and emotional support for physicians were among the least important educational areas identified. Respondents recommended delivering education via observation, bedside teaching, and participation in multidisciplinary groups.
Efforts to improve education in pediatric palliative care are needed. A palliative care team could facilitate palliative care education through engaging trainees in "real-life" interactions. The role of physicians in providing spiritual support and the need for educating physicians in obtaining emotional support for themselves merit further investigation.
美国儿科学会建议儿科医生熟悉并乐于提供姑息治疗。
该研究的目标包括：确定儿科住院医师和研究员在姑息治疗沟通及症状管理方面的培训程度、知识水平、经验、舒适度和能力；了解住院医师和研究员对关键姑息治疗概念的看法；确定姑息治疗教育的主题和方法；以及找出住院医师和研究员在回答上的差异。
设计/方法：在2006 - 2007学年，儿科住院医师和研究员完成了一项关于以下方面的调查：提供姑息治疗的培训、经验、知识、能力和舒适度；姑息治疗实践；以及关于提供姑息治疗教育的建议。
分别有52名（60%）住院医师和44名（62%）研究员完成了调查。住院医师和研究员表示在姑息治疗方面的培训、经验、知识、能力和舒适度处于无到中等水平。大多数受访者表示他们将从更正规的姑息治疗培训中受益。受访者认为讨论预后、传达坏消息和疼痛控制是需要教育的三个最重要领域。了解在精神上支持家庭以及对医生的情感支持是被认为最不重要的教育领域之一。受访者建议通过观察、床边教学和参与多学科小组来进行教育。
需要努力改进儿科姑息治疗教育。姑息治疗团队可以通过让受训者参与“现实生活”中的互动来促进姑息治疗教育。医生在提供精神支持方面的作用以及对医生进行自我情感支持教育的必要性值得进一步研究。
