全科医生对向非工作时间合作机构传递绝症患者信息的看法。
GPs' views on transfer of information about terminally ill patients to the out-of-hours co-operative.
机构信息
Department of General Practice, and EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
出版信息
BMC Palliat Care. 2009 Dec 22;8:19. doi: 10.1186/1472-684X-8-19.
BACKGROUND
In the Netherlands, the increase in of out-of-hours care that is provided by GP co-operatives is challenging the continuity of care for the terminally ill in general practice. Aim of this study is to investigate the views of general practitioners (GPs) on the transfer of information about terminally ill patients to the GP co-operatives. GPs were asked to give their view from two different perspectives: as a GP in their daily practice and as a locum in the GP co-operative.
METHODS
Retrospective web based questionnaire sent to all 424 GPs in the Amsterdam region.
RESULTS
With a response rate of 42%, 177 physicians completed the questionnaire. Transfer of information to the GP co-operative about most of their terminally ill patients was reported by 82% of the GPs and 5% did not do so for any of their patients. A faster than foreseen deterioration of the patient's situation was the most frequently reported reason for not transferring information. Of those who transferred information to the GP co-operative, more than 95% reported that they provided information about the diagnosis and terminally ill status of the patient. Information about medication, patient wishes regarding treatment, and prognosis was reported by respectively 90%, 87%, and 74% of the GPs. Less than 50% of the GPs reported that they transferred information about the patient's awareness of both the diagnosis and the prognosis, about the psychosocial context, and intolerances. In their role as locum, over 90% of the GPs wanted to receive information about the diagnosis, the terminally ill status of the patient, the medication and the patient's wishes regarding treatment.
CONCLUSIONS
Although most GPs reported that they transferred information about their terminally ill patients to the GP co-operative, the content of this information varies considerably. Only 21% of the GPs, working out of hours as a locum, were satisfied with the quality of the information transferred.
背景
在荷兰,由全科医生合作社提供的额外门诊服务增加了对普通诊所临终关怀连续性的挑战。本研究旨在调查全科医生(GP)对向全科医生合作社转移临终患者信息的看法。要求 GP 从两个不同的角度来表达他们的观点:作为他们日常实践中的 GP 和作为全科医生合作社的替代医生。
方法
回顾性网络问卷调查发送给阿姆斯特丹地区的所有 424 名 GP。
结果
应答率为 42%,有 177 名医生完成了问卷调查。82%的 GP 报告将大多数临终患者的信息转交给了全科医生合作社,而 5%的 GP 没有将任何患者的信息转交给合作社。患者病情恶化速度快于预期是最常报告的不转递信息的原因。在将信息转交给全科医生合作社的医生中,超过 95%的医生报告提供了有关患者诊断和临终状态的信息。有 90%、87%和 74%的 GP 报告提供了有关药物、患者对治疗的意愿和预后的信息。不到 50%的 GP 报告他们转递了关于患者对诊断和预后、心理社会背景和不耐受的意识的信息。作为替代医生,超过 90%的 GP 希望收到有关诊断、患者临终状态、药物和患者对治疗意愿的信息。
结论
尽管大多数 GP 报告说他们将临终患者的信息转交给了全科医生合作社,但这些信息的内容差异很大。只有 21%的 GP(作为替代医生在非工作时间工作)对转递的信息质量感到满意。