University of Rangueil, Toulouse, France.
Palliat Med. 2010 Jan;24(1):60-7. doi: 10.1177/0269216309107012. Epub 2009 Oct 1.
The purpose of this study is to analyze French general practitioners' attitudes toward prescribing opiate painkillers for dying patients and compare them with their attitudes toward making frequent home visits. One hundred and fifteen general practitioners indicated the acceptability of prescribing opiates in 48 scenarios of terminal cancer patients with different levels of age, gender, stated pain, request for painkillers, and signs of depression; 103 of them also indicated the acceptability of making frequent home visits in the same 48 scenarios. The responses were analyzed using analysis of variance and cluster analysis. For prescribing opiates, four clusters of physicians were found: 13 prescribed primarily in response to stated pain; 43 to request for painkillers; 43 to the combination of pain, request, and depression; and 16 in virtually all cases. Using the same clusters to analyze visiting gave results that were very consistent with those for prescribing. We conclude that French general practitioners have differing and consistent styles in prescribing painkillers and making home visits to dying cancer patients.
本研究旨在分析法国全科医生对为临终患者开阿片类止痛药的态度，并将其与他们对频繁家访的态度进行比较。115 名全科医生在 48 个不同年龄、性别、自述疼痛、要求止痛药和抑郁迹象的终末期癌症患者的场景中，对开阿片类药物的可接受性进行了评估；其中 103 人还对在相同的 48 个场景中进行频繁家访的可接受性进行了评估。使用方差分析和聚类分析对这些回答进行了分析。在开阿片类药物方面，发现了 4 组医生：13 名医生主要根据自述疼痛开处方；43 名医生根据要求开止痛药；43 名医生根据疼痛、要求和抑郁综合情况开处方；16 名医生几乎在所有情况下都开处方。使用相同的聚类来分析家访，结果与开处方非常一致。我们得出结论，法国全科医生在为临终癌症患者开止痛药和进行家访方面有不同但一致的风格。
