Peh Tan Ying, Yang Grace Meijuan, Krishna Lalit Kumar Radha, Yee Alethea Chung Peng
Division of Palliative Medicine, National Cancer Centre Singapore , Singapore .
J Palliat Med. 2017 Feb;20(2):141-146. doi: 10.1089/jpm.2016.0293. Epub 2016 Oct 17.
Doctors report inadequate training and lack confidence in providing palliative care. Although palliative care training improves self-assessed competence, it is not known whether the duration of a palliative medicine (PM) posting affects the extent of improvement in confidence.
The aim of this study was to determine whether the duration of a PM posting affects the extent of improvement in doctors' confidence in various aspects of palliative care.
This was a retrospective study analyzing doctors' self-rated competence level in different aspects of palliative care at the start and end of a PM posting. The change in scores was analyzed to determine the extent of improvement corresponding to the length of the posting. Seventy-one residents and medical officers participated in the study, which was conducted in a hospital-based palliative care consultative service.
Participants reported low baseline self-rated competence in palliative care. A longer posting duration resulted in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication.
A one-month posting may suffice in training a doctor in basic end-of-life medical issues, but a longer posting duration results in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication. Trainee doctors in specialties that frequently deal with terminally ill patients should undertake a longer posting in PM to be further equipped with greater confidence to better care for these patients.
医生报告称在提供姑息治疗方面培训不足且缺乏信心。尽管姑息治疗培训可提高自我评估的能力，但尚不清楚姑息医学（PM）轮值的时长是否会影响信心提升的程度。
本研究的目的是确定PM轮值的时长是否会影响医生在姑息治疗各个方面信心提升的程度。
这是一项回顾性研究，分析医生在PM轮值开始和结束时在姑息治疗不同方面的自我评定能力水平。分析分数变化以确定与轮值时长相对应的提升程度。71名住院医师和医务人员参与了这项在一家医院姑息治疗咨询服务部门开展的研究。
参与者报告称在姑息治疗方面基线自我评定能力较低。轮值时间越长，医生在姑息治疗不同领域的信心提升越大，尤其是在临终沟通方面。
为期一个月的轮值可能足以让医生接受基本的临终医疗问题培训，但轮值时间越长，医生在姑息治疗不同领域的信心提升越大，尤其是在临终沟通方面。经常处理绝症患者的专科实习医生应进行更长时间的PM轮值，以更有信心地更好照顾这些患者。
