Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Radiation Oncology, Florida Hospital Cancer Institute, Orlando, Florida.
Pract Radiat Oncol. 2017 Nov-Dec;7(6):e439-e448. doi: 10.1016/j.prro.2017.03.007. Epub 2017 Mar 14.
Although palliative care is recognized as integral to oncology care, limited data exist regarding the extent to which palliative care training is incorporated into radiation oncology residency training in the United States. We aim to characterize US radiation oncology residents' perceived palliative care educational needs and experience to guide future palliative oncology educational interventions.
An 8-person expert panel developed a survey to assess resident perceptions of generalist palliative care education within radiation oncology residency. Domains of palliative oncology education, derived from national guidelines, included symptom management (pain and non-pain), communication about goals of care, advance care planning, psychosocial issues, cultural considerations, spiritual needs, care coordination, and ethical/legal issues. Residents rated adequacy of their training and their perceived competency in each domain. A total of 433 US radiation oncology residents were identified for participation; 404 completed the survey (response rate, 93%).
Residents characterized themselves as "not at all/minimally/somewhat confident" in their ability to take care of patients with palliative care issues in the following domains: symptom management (36% pain, 44% non-pain), communication about goals of care (31%), advance care planning (48%), psychosocial (55%), cultural (22%), spiritual (44%), care coordination (50%), and ethical/legal (50%). On average, 79% of residents rated their training as "not/minimally/somewhat" adequate across all domains. Most (96%) view palliative care as an important competency within radiation oncology and 81% desire more palliative care education.
Although the majority of residents view palliative care as an important competency for radiation oncologists, a majority perceived their educational training as inadequate across multiple domains. Most residents desire further palliative oncology care training. These findings suggest efforts should be made to improve palliative care education during radiation oncology training.
尽管姑息治疗被认为是肿瘤学治疗的重要组成部分，但关于姑息治疗培训在美国放射肿瘤学住院医师培训中融入程度的相关数据有限。我们旨在描述美国放射肿瘤学住院医师对姑息治疗教育的需求和体验，以指导未来的姑息肿瘤学教育干预措施。
一个由 8 人组成的专家小组制定了一项调查，以评估住院医师对放射肿瘤学住院医师培训中综合姑息治疗教育的看法。姑息肿瘤学教育领域是从国家指南中衍生出来的，包括症状管理（疼痛和非疼痛）、关于治疗目标的沟通、预先护理计划、心理社会问题、文化考虑因素、精神需求、护理协调以及伦理/法律问题。住院医师评估了他们在每个领域的培训充足程度及其对自己能力的认知。共确定了 433 名美国放射肿瘤学住院医师参与；有 404 人完成了调查（回应率为 93%）。
住院医师认为自己在以下领域照顾姑息治疗患者的能力“一点也不/非常低/有点自信”：症状管理（36%的疼痛，44%的非疼痛）、关于治疗目标的沟通（31%）、预先护理计划（48%）、心理社会（55%）、文化（22%）、精神（44%）、护理协调（50%）和伦理/法律（50%）。平均而言，79%的住院医师认为他们在所有领域的培训“非常低/非常低/有点低”。大多数（96%）住院医师认为姑息治疗是放射肿瘤学中的一项重要能力，81%的人希望接受更多的姑息治疗教育。
尽管大多数住院医师认为姑息治疗是放射肿瘤学家的一项重要能力，但大多数人认为他们在多个领域的教育培训都不足。大多数住院医师都希望接受更多的姑息肿瘤学护理培训。这些发现表明，应努力改善放射肿瘤学培训期间的姑息治疗教育。
