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医学生对临终阶段的思考:一段临终关怀经历

Medical Students Reflections Toward End-of-Life: a Hospice Experience.

作者信息

Bovero Andrea, Tosi Chiara, Miniotti Marco, Torta Riccardo, Leombruni Paolo

机构信息

Clinical Psychology and Psycho-Oncology Unit, Department of Neurosciences, University of Turin, Turin, Italy.

出版信息

J Cancer Educ. 2018 Jun;33(3):634-639. doi: 10.1007/s13187-017-1171-1.

Abstract

In this study, we want to investigate the personal reflections toward care of the dying cancer patients among second year medical students. Two hundred fifty second year medical students attended an elective short course on end-of-life care and a brief training at the hospice Valletta, in Turin. After group discussion, the students explained their reflections about their experience. Two different supervisors of the study analyzed themes of the students and subdivided them in categories according to the frequency. The most recurrent themes were symptoms, coping skills, distress, hospice, and insight. Each theme is subdivided in categories. In 95 of 250 transcriptions, students talked about symptom (38%), 60 transcriptions (24%) were focused on coping skills. In 45 transcriptions (18%) students described emotional distress, and in the other 30 (12%) transcriptions, they pinpointed hospice philosophy. Finally, 20 recorded data (8%) were characterized by insight theme. These results have emphasized the need to integrate the clinical training with an experiential training that prepares future doctors for dealing with suffering and death. The qualitative analysis of the reflections showed that the students gained a deep appreciation of the human identity of hospice patients and the relevance of a humanistic approach to care as future physicians.

摘要

在本研究中,我们想要调查二年级医学生对临终癌症患者护理的个人思考。250名二年级医学生参加了一个关于临终关怀护理的选修短期课程,并在都灵的瓦莱塔临终关怀院接受了简短培训。经过小组讨论后,学生们解释了他们对自身经历的思考。该研究的两名不同导师分析了学生们的主题,并根据出现频率将其细分为不同类别。最常出现的主题是症状、应对技巧、痛苦、临终关怀院以及深刻理解。每个主题又进一步细分。在250份文字记录中,有95份(38%)学生谈到了症状,60份(24%)聚焦于应对技巧。45份文字记录(18%)中,学生描述了情绪痛苦,另外30份(12%)文字记录中,他们明确了临终关怀理念。最后,20份记录数据(8%)以深刻理解主题为特征。这些结果强调了将临床培训与体验式培训相结合的必要性,这种培训能让未来的医生为应对痛苦和死亡做好准备。对这些思考的定性分析表明,作为未来的医生,学生们对临终关怀院患者的人性身份以及人文关怀方法的相关性有了深刻认识。

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