Kiely Fiona, Murphy Marie, O'Brien Tony
Dr Fiona Kiely, Department of Palliative Medicine, Marymount University Hospice and University College, Cork, Ireland.
BMJ Support Palliat Care. 2013 Dec;3(4):405-11. doi: 10.1136/bmjspcare-2012-000281. Epub 2012 Nov 21.
In Ireland, weekend and night medical cover for community based patients is largely provided by general practice co-operatives. Doctors working in this service do not have direct access to patients' medical records which challenges continuity of care.
This study investigates the opinion of general practitioners (GPs) on the potential value of a formalised method of information transfer regarding their palliative patients to out-of-hours GP co-operatives. The survey was designed to identify the information that is necessary to offer appropriate anticipated end-of-life care.
A questionnaire was sent to all 414 GPs registered in the Irish Medical Directory in the southwest of Ireland. Data were analysed with Microsoft Excel and SPSS V.12.0.
52% response rate with exclusion of incomplete questionnaires allowed analysis of 212 data sets. Currently, 82% of GPs do not routinely transfer information pertaining to end-of-life issues to the out-of-hours service. Despite this, 96% would value a standardised way of transferring information. 67% felt they sometimes refer unnecessarily to hospital emergency departments due to lack of information. The most important items of information identified by study participants are as follows: ▸ Diagnosis (97%) ▸ Medications (94%) ▸ Patient insight (91%) ▸ Patient wishes regarding end-of-life care (90%) ▸ Anticipated problems and suggested management(90%).
A structured format for information transfer regarding end-of-life care is deemed important by GPs when working on-call at night and weekends. Diagnosis, patient preference and management plans are valued.
在爱尔兰，社区患者的周末和夜间医疗服务主要由全科医疗合作社提供。在此服务中工作的医生无法直接获取患者的病历，这对医疗的连续性构成了挑战。
本研究调查了全科医生（GP）对于将其姑息治疗患者的信息以一种正式方法传递给非工作时间的全科医疗合作社的潜在价值的看法。该调查旨在确定提供适当的预期临终关怀所需的信息。
向爱尔兰西南部《爱尔兰医学名录》中注册的所有414名全科医生发送了一份问卷。数据用Microsoft Excel和SPSS V.12.0进行分析。
排除不完整问卷后，回复率为52%，可对212个数据集进行分析。目前，82%的全科医生不会定期将与临终问题相关的信息传递给非工作时间服务机构。尽管如此，96%的医生认为需要一种标准化的信息传递方式。67%的医生觉得由于缺乏信息，他们有时会不必要地将患者转诊至医院急诊科。研究参与者确定的最重要的信息项目如下：
诊断（97%）
药物（94%）
患者的认知（91%）
患者关于临终关怀的意愿（90%）
预期问题及建议处理方法（90%）。
当在夜间和周末值班时，全科医生认为一种关于临终关怀的结构化信息传递格式很重要。诊断、患者偏好和管理计划受到重视。
