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一种向实习医生教授儿科姑息治疗的纵向教学方法:关于实习医生舒适度水平变化的初步发现。

A longitudinal method of teaching pediatric palliative care to interns: preliminary findings regarding changes in interns' comfort level.

机构信息

Department of Pediatrics, David Geffen School of Medicine, University of California-Los Angeles, 10833 Le Conte Avenue, Los Angeles, CA 90095-1752, USA.

出版信息

Palliat Support Care. 2010 Mar;8(1):35-40. doi: 10.1017/S147895150999068X. Epub 2010 Feb 18.

Abstract

OBJECTIVE

A longitudinal pediatric palliative care curriculum was introduced into the pediatric residency program at the University of California, Los Angeles. The present study explores the possible effects of this curriculum on the interns' self-assessed comfort levels regarding caring for children with life-threatening conditions.

METHODS

A newly created assessment tool was administered to interns in order to rate their comfort regarding pediatric palliative care at the beginning and conclusion of their intern year.

RESULTS

Twenty-two of the 29 interns completed this survey. Baseline data indicated 55% of the interns had some experience with taking care of a dying pediatric patient during their medical school training, and 79% indicated that they had taken care of a dying adult. Only 7% of the interns felt adequately prepared to deal with death and dying, but all interns indicated interest in further learning about pediatric palliative care. Comparison of the overall comfort levels of the 22 responding residents before and after the first year of training in 20 different related tasks demonstrated a significant self-assessed improvement of comfort in seven areas. There was no increase in self-reported comfort in communication related to palliative care.

SIGNIFICANCE OF RESULTS

Residents indicated increased comfort in some areas of pediatric palliative care after the first year of their training. The underlying cause of this increased comfort is unclear at this time. The overall effect of longitudinal palliative care curricula on residents' level of comfort in caring for this population deserves further assessment.

摘要

目的

加州大学洛杉矶分校将儿科姑息治疗课程纳入住院医师培训项目。本研究旨在探讨该课程对住院医师自我评估在处理危及生命疾病儿童方面的舒适度的可能影响。

方法

为住院医师设计了一个新的评估工具,用于在他们的住院医师培训年初和年末评估他们在儿科姑息治疗方面的舒适度。

结果

29 名住院医师中有 22 名完成了这项调查。基线数据表明,55%的住院医师在医学院培训期间有过照顾临终儿科患者的经验,79%的住院医师表示照顾过临终成人。只有 7%的住院医师觉得自己有足够的准备来应对死亡和濒死,但所有住院医师都表示有兴趣进一步学习儿科姑息治疗。在 20 项不同相关任务中,比较 22 名有反应的住院医师在第一年培训前后的整体舒适度水平,在七个领域显示出自我评估舒适度的显著提高。在与姑息治疗相关的沟通方面,自我报告的舒适度没有增加。

结果的意义

住院医师在培训的第一年之后,在一些儿科姑息治疗领域的舒适度有所提高。这种舒适度增加的根本原因目前尚不清楚。纵向姑息治疗课程对住院医师照顾这一人群的舒适度水平的总体影响值得进一步评估。

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