Kizawa Yoshiyuki, Morita Tatsuya, Miyashita Mitsunori, Shinjo Takuya, Yamagishi Akemi, Suzuki Satoshi, Kinoshita Hiroya, Shirahige Yutaka, Yamaguchi Takuhiro, Eguchi Kenji
Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Department of Palliative and Supportive Care, Palliative Care Team, and Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
J Pain Symptom Manage. 2015 Aug;50(2):232-40. doi: 10.1016/j.jpainsymman.2015.02.025. Epub 2015 Apr 4.
Although several studies have explored the effects of regional palliative care programs, no studies have investigated the changes in physician-related outcomes.
The primary aims of this study were to: (1) clarify the changes in knowledge, difficulties, and self-reported practice of physicians before and after the intervention, (2) explore the potential associations between the level of physicians' participation in the program and outcomes, and (3) identify the reasons and characteristics of physicians who did not participate in the program.
As a part of the regional palliative care intervention trial, questionnaires were sent to physicians recruited consecutively to obtain a representative sample of each region. Physician-reported knowledge, difficulty of palliative care, and self-perceived practice were measured using the Palliative Care Knowledge Test, Palliative Care Difficulty Scale, and Palliative Care Self-Reported Practice Scale (PCPS), respectively. The level of their involvement in the program and reason for non-participation were ascertained from self-reported questionnaires.
The number of eligible physicians identified was 1870 in pre-intervention and 1763 in post-intervention surveys, and we obtained 911 and 706 responses. Total scores of the Palliative Care Knowledge Test, PCPS, and PCPS were significantly improved after the intervention, with effect sizes of 0.30, 0.52, and 0.17, respectively. Physicians who participated in workshops more frequently were significantly more likely to have better knowledge, less difficulties, and better self-reported practice.
After the regional palliative care program, there were marked improvements in physicians' knowledge and difficulties. These improvements were associated with the level of physicians' participation in the program.
尽管多项研究探讨了区域姑息治疗项目的效果，但尚无研究调查与医生相关的结果变化。
本研究的主要目的是：（1）明确干预前后医生在知识、困难及自我报告的实践方面的变化；（2）探讨医生参与项目的程度与结果之间的潜在关联；（3）确定未参与项目的医生的原因和特征。
作为区域姑息治疗干预试验的一部分，向连续招募的医生发放问卷，以获取每个区域的代表性样本。分别使用姑息治疗知识测试、姑息治疗困难量表和姑息治疗自我报告实践量表（PCPS）来测量医生报告的知识、姑息治疗困难程度和自我感知的实践情况。通过自我报告问卷确定他们参与项目的程度和未参与的原因。
干预前确定的符合条件的医生人数为1870名，干预后调查中有1763名，我们分别获得了911份和706份回复。干预后，姑息治疗知识测试、PCPS和PCPS的总分显著提高，效应量分别为0.30、0.52和0.17。更频繁参加研讨会的医生更有可能拥有更好的知识、更少的困难和更好的自我报告实践。
区域姑息治疗项目实施后，医生的知识和困难有显著改善。这些改善与医生参与项目的程度相关。
