加拿大安大略省金斯顿一个学术性家庭健康团队中的临终讨论。
End of life discussion in an academic family health team in kingston, ontario, Canada.
作者信息
French Reta, Zhang Wenli, Parks Kelly, Ashton Sarah, Dumas Matt, Haider Atika, Leung Lawrence
机构信息
Department of Family Medicine, Queen's University, Kingston, Ontario, K7L5E9, Canada.
Department of Family Medicine, Queen's University, Kingston, Ontario, K7L5E9, Canada ; Department of Centre of Studies in Primary Care, Queen's University, Kingston, Ontario, K7L5E9, Canada.
出版信息
J Family Med Prim Care. 2013 Jul;2(3):263-5. doi: 10.4103/2249-4863.120749.
BACKGROUND
End-of-life (EOL) discussions remain difficult in non-terminal patients as death is often perceived as a taboo and uncertainty. However, the call for proper EOL discussions has recently received public attention and media coverage. Evidence also reveals that non-terminal patients are more satisfied with health-care encounters when EOL has been discussed.
OBJECTIVES AND METHODS
The objective of this study was to explore the prevalence of EOL discussions in non-terminal adult patients, the perceived barriers to such discussions and suggested methods for improvement. A study mixed-methods study was performed by a group of PGY1 family medicine residents in an academic health team in Kingston, Ontario.
RESULTS
EOL discussion was performed in a very small proportion of non-terminal patient encounters. Compared with attending physicians, residents were less likely to discuss EOL issues and reported more perceived barriers.
CONCLUSION
Our findings reflect the need for an early and open approach in conducting EOL discussion for non-terminal healthy patients.
背景
对于非终末期患者而言，临终讨论依旧困难重重，因为死亡常常被视为一种禁忌和不确定因素。然而，近期关于进行恰当临终讨论的呼吁已受到公众关注和媒体报道。证据还表明，当进行了临终讨论时，非终末期患者对医疗服务体验更为满意。
目的与方法
本研究的目的是探究非终末期成年患者中临终讨论的发生率、此类讨论所感知到的障碍以及改进的建议方法。安大略省金斯顿一个学术健康团队中的一群一年级家庭医学住院医师开展了一项混合方法研究。
结果
在极少比例的非终末期患者诊疗过程中进行了临终讨论。与主治医生相比，住院医师讨论临终问题的可能性较小，且报告称感知到的障碍更多。
结论
我们的研究结果表明，对于非终末期健康患者进行临终讨论需要采取早期且开放的方法。
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