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荷兰全科医生提供非工作时间姑息治疗的情况。

Availability of Dutch General Practitioners for After-Hours Palliative Care.

作者信息

Plat Fredrik M, Peters Yvonne A S, Giesen Paul, Smits Marleen

机构信息

1 Scientific Center for Quality of Healthcare (IQ Healthcare), Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.

2 IMPULS, Radboud University Medical Center, Nijmegen, the Netherlands.

出版信息

J Palliat Care. 2018 Jul;33(3):182-186. doi: 10.1177/0825859718766947. Epub 2018 Apr 2.

Abstract

BACKGROUND

Continuity of care is important for palliative patients in their end of life. In the Netherlands, after-hours primary care for palliative patients is either provided by large-scale general practitioner (GP) cooperatives or GPs choose to give palliative care by themselves while they are not on duty.

AIM

To examine the availability of, perceived problems by, and attitude of Dutch GPs regarding providing palliative care for their own patients outside office hours.

DESIGN AND SETTING

Cross-sectional observational study among 1772 GPs from 10 Dutch regions.

METHOD

Online questionnaire among GPs affiliated with 10 GP cooperatives.

RESULTS

Five hundred twenty-four (29.6%) eligible questionnaires were returned. Of the GPs, 60.8% were personally available outside office hours for their own palliative patients on their own private cell phone and performed home visits if needed. In 33.0%, GPs were willing to make home visits in private time instigated by the GP cooperative and 26.8% were only accessible for telephone consultation by the GP cooperative. In 12.2%, the GP delegated after-hours palliative care completely to the GP cooperative. The GPs predominantly reported "time pressure" problems (17.3%) as a barrier and 61.7% stated that after-hours palliative care is the responsibility of the own GP.

CONCLUSION

The large majority of Dutch GPs is personally available for telephone consultation and/or willing to provide palliative care for their own patients outside office hours. For the future, it is important to maintain the willingness of GPs to remain personally available for their palliative patients.

摘要

背景

临终关怀对姑息治疗患者的持续护理至关重要。在荷兰,姑息治疗患者的非工作时间初级护理要么由大型全科医生(GP)合作社提供,要么由全科医生选择在非工作时间自行提供姑息治疗。

目的

研究荷兰全科医生在办公时间之外为自己的患者提供姑息治疗的可及性、感知到的问题以及态度。

设计与背景

对来自荷兰10个地区的1772名全科医生进行横断面观察研究。

方法

对隶属于10个全科医生合作社的全科医生进行在线问卷调查。

结果

共返回524份(29.6%)合格问卷。在这些全科医生中,60.8%在办公时间之外会用自己的私人手机亲自为自己的姑息治疗患者提供服务,并在需要时进行家访。33.0%的全科医生愿意在全科医生合作社的要求下在私人时间进行家访,26.8%的全科医生仅接受全科医生合作社的电话咨询。12.2%的全科医生将非工作时间的姑息治疗完全委托给全科医生合作社。全科医生主要报告“时间压力”问题(17.3%)是一个障碍,61.7%的人表示非工作时间的姑息治疗是自己作为全科医生的责任。

结论

绝大多数荷兰全科医生个人可接受电话咨询和/或愿意在办公时间之外为自己的患者提供姑息治疗。对于未来而言,维持全科医生愿意亲自为其姑息治疗患者提供服务的意愿非常重要。

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