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新生儿病房的姑息治疗教育:对知识和态度的影响

Palliative care education in neonatal units: impact on knowledge and attitudes.

作者信息

Twamley Katherine, Kelly Paula, Moss Rebecca, Mancini Alexandra, Craig Finella, Koh Michelle, Polonsky Reen, Bluebond-Langner Myra

机构信息

Louis Dundas Centre for Children's Palliative Care, UCL Institute of Child Health, London, UK.

出版信息

BMJ Support Palliat Care. 2013 Jun;3(2):213-20. doi: 10.1136/bmjspcare-2012-000336. Epub 2012 Dec 15.

Abstract

OBJECTIVE

To facilitate improved and earlier access to palliative care for babies, a 4-h workshop on the principles, practice and resources in palliative care was delivered in 21 neonatal units across London. This paper assesses the impact of these workshops.

DESIGN

As part of mixed methods, processual evaluation of a series of education workshops, a pre and post survey instrument was developed, consisting of open and closed questions assessing knowledge of services and attitudes towards palliative care. Before and after each workshop attendees were invited to complete the survey.

SETTING

Neonatal units in hospitals across London, including examples of intensive care, high dependency and special care units.

RESULTS

331 healthcare professionals attended the sessions, and 264 (80%) completed questionnaires. The majority of attendees were experienced neonatal nurses working in neonatal intensive care  (61% more than 7 years) but with limited experience of palliative care services. Over 79% of respondents reported that the workshop completely met their learning needs. Post-session 80% of respondents felt confident referring to palliative care services, compared with 46% before (p<0.001). Analysis of open and closed text responses revealed a shift in attitude after the sessions from a focus on dying/end-of-life, towards integrating palliative care as part of a holistic treatment plan.

CONCLUSIONS

A short (half day), locally delivered workshop can change attitudes and increase knowledge in neonatal staff. Such a workshop can serve as a first step in facilitating access to and utilisation of a variety of palliative care services.

摘要

目的

为了让婴儿能更早地获得更好的姑息治疗,在伦敦的21个新生儿病房举办了一场关于姑息治疗原则、实践和资源的4小时工作坊。本文评估了这些工作坊的影响。

设计

作为对一系列教育工作坊进行混合方法、过程性评估的一部分,开发了一份前后调查问卷,包括开放式和封闭式问题,用于评估对服务的了解以及对姑息治疗的态度。在每个工作坊前后,邀请参与者完成调查问卷。

地点

伦敦各地医院的新生儿病房,包括重症监护、高依赖和特殊护理病房的例子。

结果

331名医护人员参加了这些课程,264人(80%)完成了问卷调查。大多数参与者是在新生儿重症监护室工作的经验丰富的新生儿护士(61%超过7年),但对姑息治疗服务的经验有限。超过79%的受访者表示,该工作坊完全满足了他们的学习需求。课后,80%的受访者表示有信心推荐姑息治疗服务,而课前这一比例为46%(p<0.001)。对开放式和封闭式文本回复的分析显示,课程结束后,态度从关注死亡/生命末期,转向将姑息治疗作为整体治疗计划的一部分。

结论

一个简短的(半天)、在当地举办的工作坊可以改变新生儿医护人员的态度并增加他们的知识。这样的工作坊可以作为促进获得和利用各种姑息治疗服务的第一步。

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