Ray Robin A, Fried Ofra, Lindsay Daniel
College of Medicine and Dentistry, Anton Breinl Research Centre for Health System Strengthening, James Cook University, Townsville 4811, Australia.
BMC Health Serv Res. 2014 Jun 19;14:272. doi: 10.1186/1472-6963-14-272.
People living in rural and remote locations are disadvantaged in accessing palliative care. This can be attributed to several factors including the role diversity and the low numbers of patients with specific conditions, as well as the difficulties rural health practitioners have in accessing opportunities for professional education. A program of multidisciplinary palliative care video conferences was presented to health practitioners across part of northern Australia in an effort to address this problem.
The educational content of the video conferences was developed from participant responses to an educational needs assessment. Following cycles of four consecutive video conferences, 101 participants completed evaluative on-line surveys. The quantitative data were analysed using frequencies and analysis of variance tests with post-hoc analyses where appropriate, and an accessibility and remoteness index was used to classify their practice location.
All participants found the content useful regardless of their remoteness from the tertiary centre, their years of experience caring for palliative care patients or the number of patients cared for each year. However, change in confidence to provide palliative care as a result of attending the video conferences was significant across all disciplines, regardless of location. Doctors, medical students and allied health professionals indicated the greatest change in confidence.
The provision of professional education about palliative care issues via multidisciplinary video conferencing increased confidence among rural health practitioners, by meeting their identified need for topic and context specific education. This technology also enhanced the networking opportunities between practitioners, providing an avenue of ongoing professional support necessary for maintaining the health workforce in rural and remote areas. However, more attention should be directed to the diverse educational needs of allied health professionals.
生活在农村和偏远地区的人们在获得姑息治疗方面处于不利地位。这可归因于多种因素,包括角色多样性、特定疾病患者数量少,以及农村卫生从业人员在获得专业教育机会方面存在困难。为了解决这一问题,向澳大利亚北部部分地区的卫生从业人员提供了多学科姑息治疗视频会议项目。
视频会议的教育内容是根据参与者对教育需求评估的反馈制定的。在连续进行四轮视频会议后,101名参与者完成了在线评估调查。定量数据采用频率分析和方差分析,并在适当情况下进行事后分析,使用可达性和偏远指数对他们的执业地点进行分类。
所有参与者都认为内容有用,无论他们离三级中心的距离、照顾姑息治疗患者的年限或每年照顾的患者数量如何。然而,无论地点如何,参加视频会议后提供姑息治疗的信心在所有学科中都有显著变化。医生、医学生和专职医疗人员表示信心变化最大。
通过多学科视频会议提供有关姑息治疗问题的专业教育,满足了农村卫生从业人员对特定主题和背景教育的需求,从而增强了他们的信心。这项技术还增加了从业人员之间的交流机会,为维持农村和偏远地区的卫生人力提供了持续专业支持的途径。然而,应更多关注专职医疗人员多样化的教育需求。