Qu Xuan, Jiang Nan, Ge Nan, Ning Xiao Hong
Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Chin Med Sci J. 2018 Dec 30;33(4):228-233. doi: 10.24920/003515.
Objective s The in-hosptial palliative care consultation (PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital. Methods In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team, and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients,their family as well as the primary care team. Physicians who applied for consultation in 2016 formally (requested from the department other than the Geriatrics) and informally (by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform. Results There were 103 physicians participated in the survey, including primary care physicians from the department of Internal Medicine (n=8), Gynaecology (n=16) and Surgery (n=13), rotating residents (n=30), visiting doctors (n=16) in Geriatric department, and PCC team members (n=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients' life; there were 91.6%, 95.2%, 90.4% physicians who felt it relieved the anxiety of patients, of family members and of care providers, respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence, and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree "PCC service helps the physicians better understand palliative care" than PCC members (97.6% vs. 80%, P<0.05), while both were interested in learning more on palliative medicine (100% vs. 96.4%, P>0.05). Conclusion Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients, family members, and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.
目的 住院姑息治疗会诊（PCC）在中国一些医疗中心正逐渐成为一项常规服务。本研究评估了基层医疗团队和会诊团队的医生对PCC服务的看法，以调查该会诊模式在综合医院中的有效性。方法 北京协和医院由一个专门的会诊团队开展住院姑息治疗会诊，2016年共完成37次会诊。针对医生设计了一份问卷，内容涉及PCC对患者、其家属以及基层医疗团队的益处。邀请2016年正式申请会诊（从老年医学科以外的科室申请）和非正式申请会诊（由老年医学科轮转住院医师和进修医生）的医生通过扫描社交网络平台上的二维码参与调查。结果 共有103名医生参与了调查，包括内科（n = 8）、妇科（n = 16）和外科（n = 13）的基层医疗医生、轮转住院医师（n = 30）、老年医学科进修医生（n = 16）以及PCC团队成员（n = 20）。94.0%的非PCC医生认为PCC减轻了患者的痛苦；89.2%认为PCC提高了患者的生活质量；分别有91.6%、95.2%、90.4%的医生认为PCC缓解了患者、家属和护理人员的焦虑。96.4%的医生认为PCC可以缓解医患关系紧张；97.6%认为PCC降低了医疗过失风险，96.4%申请PPC的医生对PCC服务的过程和会诊目标达成情况感到满意。更多基层医疗团队医生认同“PCC服务有助于医生更好地理解姑息治疗”，高于PCC成员（97.6%对80%，P < 0.05），而两者都有兴趣进一步学习姑息医学（1,00%对96.4%，P > 0.05）。结论 综合医院的姑息治疗会诊服务有效且广受好评。基层医疗医生和PCC成员对PCC服务给患者、家属以及医生自身带来的益处持积极态度。综合医院为终末期患者提供PCC可能是中国推广姑息治疗的一个良好模式。
