Manu Erika, Marks Adam, Berkman Cathy S, Mullan Patricia, Montagnini Marcos, Vitale Caroline A
Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI 48109, USA.
J Cancer Educ. 2012 Jun;27(3):515-20. doi: 10.1007/s13187-012-0351-2.
To examine medical residents' perceived competence in caring for patients with dementia we conducted an online survey of all 120 second, third and fourth-year residents in Internal Medicine, Medicine/Pediatrics, and Family Medicine at University of Michigan. A structured survey elicited residents' training, experience, confidence, and perceived career needs for skills in estimating prognosis, symptom management, and communication in caring for patients with dementia, compared to patients with metastatic cancer. Among the 61 (51 %) respondents, a majority report lower confidence in assessing prognosis and eliciting treatment wishes in patients with dementia (vs. metastatic cancer), and in performing skills integral to the care of patients with dementia, including the ability to assess caregiver needs, decisional capacity, advise on place of care, and manage agitation, despite viewing these skills as important to their future careers. These findings support the need for enhanced education on optimal care of patients with advanced dementia.
为了调查住院医师照顾痴呆患者的感知能力，我们对密歇根大学内科、内科/儿科和家庭医学专业的所有120名二、三、四年级住院医师进行了在线调查。与转移性癌症患者相比，一份结构化调查问卷引出了住院医师在评估痴呆患者预后、症状管理和沟通方面的培训、经验、信心以及感知到的职业技能需求。在61名（51%）受访者中，大多数人表示在评估痴呆患者（与转移性癌症患者相比）的预后和引出治疗意愿方面，以及在执行痴呆患者护理所需技能方面信心较低，这些技能包括评估护理人员需求、决策能力、提供护理地点建议以及管理激越行为，尽管他们认为这些技能对其未来职业很重要。这些发现支持了加强晚期痴呆患者最佳护理教育的必要性。
