Frey Rosemary, Gott Merryn, Raphael Deborah, O'Callaghan Anne, Robinson Jackie, Boyd Michal, Laking George, Manson Leigh, Snow Barry
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand Auckland District Health Board, Auckland, New Zealand.
BMJ Support Palliat Care. 2014 Dec;4(4):381-9. doi: 10.1136/bmjspcare-2012-000346. Epub 2013 Sep 30.
Central to appropriate palliative care management in hospital settings is ensuring an adequately trained workforce. In order to achieve optimum palliative care delivery, it is first necessary to create a baseline understanding of the level of palliative care education and support needs among all clinical staff (not just palliative care specialists) within the acute hospital setting.
The objectives of the study were to explore clinical staff: perceptions concerning the quality of palliative care delivery and support service accessibility, previous experience and education in palliative care delivery, perceptions of their own need for formal palliative care education, confidence in palliative care delivery and the impact of formal palliative care training on perceived confidence.
A purposive sample of clinical staff members (598) in a 710-bed hospital were surveyed regarding their experiences of palliative care delivery and their education needs.
On average, the clinical staff rated the quality of care provided to people who die in the hospital as 'good' (x̄=4.17, SD=0.91). Respondents also reported that 19.3% of their time was spent caring for end-of-life patients. However, only 19% of the 598 respondents reported having received formal palliative care training. In contrast, 73.7% answered that they would like formal training. Perceived confidence in palliative care delivery was significantly greater for those clinical staff with formal palliative care training.
Formal training in palliative care increases clinical staff perceptions of confidence, which evidence suggests impacts on the quality of palliative care provided to patients. The results of the study should be used to shape the design and delivery of palliative care education programmes within the acute hospital setting to successfully meet the needs of all clinical staff.
在医院环境中，适当的姑息治疗管理的核心是确保有一支训练有素的员工队伍。为了实现最佳的姑息治疗服务，首先有必要对急症医院环境中所有临床工作人员（不仅仅是姑息治疗专家）的姑息治疗教育水平和支持需求有一个基本的了解。
本研究的目的是探讨临床工作人员对姑息治疗服务质量和支持服务可及性的看法、以往在姑息治疗服务方面的经验和教育、对自身接受正规姑息治疗教育需求的看法、对提供姑息治疗的信心以及正规姑息治疗培训对感知信心的影响。
对一家拥有710张床位的医院中的598名临床工作人员进行了有目的抽样调查，了解他们在姑息治疗服务方面的经验和教育需求。
平均而言，临床工作人员将为在医院死亡的患者提供的护理质量评为“良好”（x̄=4.17，标准差=0.91）。受访者还报告说，他们19.3%的时间用于照顾临终患者。然而，在这598名受访者中，只有19%的人报告接受过正规的姑息治疗培训。相比之下，73.7%的人回答说他们希望接受正规培训。接受过正规姑息治疗培训的临床工作人员对提供姑息治疗的感知信心明显更高。
姑息治疗方面的正规培训提高了临床工作人员的信心，有证据表明这会影响为患者提供的姑息治疗质量。该研究结果应用于指导急症医院环境中姑息治疗教育项目的设计和实施，以成功满足所有临床工作人员的需求。
