Schneider N, Engeser P, Behmann M, Kühne F, Wiese B
Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover.
Schmerz. 2011 Apr;25(2):166, 168-173. doi: 10.1007/s00482-011-1037-0.
The aim was to explore the expectations of general practitioners (GPs) towards specialized outpatient palliative care (SAPV) focused on older patients in the last phase of life.
A standardized postal survey was carried out with 1,962 GPs in Lower Saxony with an analysis of physician and practice-related factors.
The response rate was 46% (n=897) and SAPV was known to 68% of the participants (n=599) of whom 48% (n=288) assumed that SAPV will improve the healthcare for older patients in the last phase of life. The GPs favored advice by and collaborative patient care with SAPV teams. Younger and female GPs, and GPs who had been practicing for a shorter period or working in a group practice showed greater interest in collaboration than other colleagues.
The perception of patients in specialized palliative care with its current focus on cancer patients is different from the perception in general practice with its focus on geriatric and multimorbid patients. This may be a reason for the skepticism showed in this study whether SAPV will actually improve healthcare in the community. However, with respect to the concept and framework SAPV has the potential to fulfill GPs expectations and should be focused on counseling and collaborative services. The knowledge about physician and practice-related factors shaping GPs attitudes towards SAPV can be helpful to further implement SAPV into practice.
目的是探讨全科医生（GP）对专注于老年临终患者的专科门诊姑息治疗（SAPV）的期望。
对下萨克森州的1962名全科医生进行了标准化的邮寄调查，并分析了与医生和执业相关的因素。
回复率为46%（n = 897），68%的参与者（n = 599）了解SAPV，其中48%（n = 288）认为SAPV将改善老年临终患者的医疗保健。全科医生赞成由SAPV团队提供建议并进行协作式患者护理。年轻和女性全科医生，以及执业时间较短或在团体诊所工作的全科医生比其他同事对协作表现出更大的兴趣。
目前专注于癌症患者的专科姑息治疗对患者的认知与专注于老年和多病患者的全科医疗中的认知不同。这可能是本研究中对SAPV是否真的能改善社区医疗保健表示怀疑的一个原因。然而，就概念和框架而言，SAPV有潜力满足全科医生的期望，应侧重于咨询和协作服务。了解影响全科医生对SAPV态度的与医生和执业相关的因素，有助于将SAPV进一步应用于实践。
