Paediatric Advanced Care Team, Hospital for Sick Children, Toronto, ON, Canada.
J Palliat Med. 2013 Jun;16(6):675-9. doi: 10.1089/jpm.2012.0393. Epub 2013 Feb 27.
Palliative care physicians are increasingly being asked to provide end-of-life (EOL) care for children. Yet very little is known about physicians' level of comfort and willingness to do so.
This study assessed the attitudes of palliative care physicians toward providing care for pediatric patients and to describe the supports they desire in order to do so.
An online questionnaire was e-mailed to all physicians in the Division of Palliative Care at the University of Toronto. The questionnaire explored perceptions, attitudes, and level of comfort caring for pediatric patients. Results are reported using frequencies, ratios, and other descriptive analyses.
Forty-four physicians of the 74 (59%) surveyed responded. On average, physicians cared for fewer than one child per each year of practice. Although the majority of respondents perceived their pediatric training to be inadequate, 70% were willing to provide care to children. Respondents felt at ease applying their knowledge and skills in some aspects of pediatric care (e.g., principles of pain and symptom management, communication about EOL issues) but less so in others (e.g., medication dosing, ethical issues unique to pediatrics). All respondents welcomed opportunities for additional training, but a third felt it was not essential. In particular, the most frequently expressed need was for mentorship by pediatric palliative care specialists.
Palliative physicians tend to be willing to care for children, but perceive their level of training to be insufficient. Although additional training is endorsed, physicians favored real-time support and mentorship from a pediatric expert.
姑息治疗医生越来越多地被要求为儿童提供临终关怀。然而，人们对医生提供这种护理的舒适度和意愿知之甚少。
本研究评估了姑息治疗医生对为儿科患者提供护理的态度，并描述了他们希望提供的支持。
向多伦多大学姑息治疗科的所有医生发送了一份在线问卷。该问卷探讨了对照顾儿科患者的看法、态度和舒适度。结果以频率、比例和其他描述性分析报告。
在接受调查的 74 名医生中，有 44 名（59%）做出了回应。平均而言，医生每年照顾的儿童不足一人。尽管大多数受访者认为他们的儿科培训不足，但 70%的人愿意为儿童提供护理。受访者在儿科护理的某些方面（例如，疼痛和症状管理原则、临终问题的沟通）应用他们的知识和技能感到自在，但在其他方面（例如，药物剂量、儿科特有的伦理问题）则不然。所有受访者都欢迎接受额外培训的机会，但三分之一的人认为这不是必需的。特别是，他们最常表达的需求是接受儿科姑息治疗专家的指导。
姑息治疗医生往往愿意照顾儿童，但认为他们的培训水平不足。尽管人们支持额外的培训，但医生更倾向于获得儿科专家的实时支持和指导。
