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[农村地区四年的专科门诊姑息治疗:全科医生视角下的合作与可接受性]

[Four years of specialized outpatient palliative care in a rural area : Cooperation and acceptability from general practitioners' view].

作者信息

Kaiser Florian, Sohm Michael, Illig Daniela, Vehling-Kaiser Ursula, Haas Michael

机构信息

Klinik für Hämatologie und Medizinische Onkologie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.

Onkologisch-palliativmedizinisches Netzwerk Landshut, Landshut, Deutschland.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016 Jul;59(7):916-20. doi: 10.1007/s00103-016-2363-2.

Abstract

BACKGROUND

In 2011, a specialized palliative home care was introduced in the counties of Landshut and Dingolfing.

OBJECTIVES

The aim of the current survey was to evaluate the cooperation, acceptance and need of palliative measures for patients particulary from the general practitioner's perspective.

METHODS

From January to March 2015, 198 general practitioners from the counties of Landshut and Dingolfing were contacted with questionnaires. The questionnaires consisted of 16 questions covering five different issues, and drew upon the practical experiences of the authors and earlier surveys from the literature. The questionnaires were sent by post containing a self-addressed and postpaid envelope.

RESULTS

Completed questionnaires from 40 out of 198 contacted general practitioners (33 % female and 53 % male). Of these 85 % had cooperated with a SAPV team, 23 % had taken part in training for palliative medicine, 10 % intended to acquire a qualification and 10 % could imagine working in a SAPV team. In addition, 75 % stated that hospitalizations were avoided through the use of SAPV while 73 % felt that time and costs were saved for their own practices. The majority of general practitioners were satisfied with the work provided by the SAPV and the cooperation. Regarding additional palliative care for geriatric patients, 60 % believed that this was sensible. One main critique was that the information about including a patient in the SAPV program was transferred to the general practitioner too late.

CONCLUSION

The current data show that general practitioners recognize the need for palliative medicine skills and predominately welcome the work of a specialized palliative care team in treating their patients. However, close cooperation and communication is necessary for a successful network between generalists and specialists in palliative care.

摘要

背景

2011年,兰茨胡特县和丁戈尔芬县引入了专门的姑息家庭护理服务。

目的

本次调查旨在从全科医生的角度评估姑息治疗措施的合作情况、接受程度及需求,特别是针对患者。

方法

2015年1月至3月,向兰茨胡特县和丁戈尔芬县的198名全科医生发放问卷。问卷包含16个问题,涵盖五个不同方面,借鉴了作者的实践经验及文献中的早期调查。问卷通过邮寄方式发放,并附带回邮信封和邮资。

结果

198名被联系的全科医生中有40人完成问卷(女性占33%,男性占53%)。其中85%曾与姑息和临终关怀服务团队(SAPV)合作,23%参加过姑息医学培训,10%打算获取相关资质,10%考虑在SAPV团队工作。此外,75%表示通过使用SAPV避免了患者住院,73%认为为其诊所节省了时间和成本。大多数全科医生对SAPV提供的工作及合作表示满意。对于老年患者的额外姑息治疗,60%认为是合理的。一个主要批评是,关于将患者纳入SAPV项目的信息传递给全科医生的时间太晚。

结论

目前的数据表明,全科医生认识到需要掌握姑息医学技能,并且普遍欢迎专门的姑息治疗团队为其患者提供的服务。然而,姑息治疗领域的全科医生和专科医生之间要建立成功的网络,密切合作与沟通是必要的。

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