泰国医学生对“善终”的看法：一项多中心研究。

Thai medical students' attitudes regarding what constitutes a "good death": a multi-center study.

机构信息

Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

Division of Geriatric Medicine, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand.

出版信息

BMC Med Educ. 2019 Mar 8;19(1):78. doi: 10.1186/s12909-019-1510-5.

DOI:10.1186/s12909-019-1510-5

PMID:30849985

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6408792/

Abstract

BACKGROUND

Few studies exist regarding the perception of medical students toward older adults' wishes during their end-of-life period. Better understanding of students' perceptions regarding this topic could help improve palliative education. The purposes of this study were to examine the perceptions of medical students regarding what constitutes a "good death" and to demonstrate the factors associated with the necessary care decisions in older patients.

METHODS

This is a cross-sectional study. A questionnaire was developed and given to all of the medical students at two medical schools in Thailand (Siriraj and Srinagarind Hospital) from September 2017 to February 2018. They were asked to response to the questions by imagining how older people would think, and their preferences regarding care at the end-of-life period. The anonymous questionnaires were collected and analyzed.

RESULTS

A total of 1029 out of 2990 surveys were returned (34.4%). A minority of the sixth-year medical students rated themselves as being knowledgeable about palliative care (11.3%). According to the survey, desire to have spiritual needs met and have their loved ones present were the most important conditions that contributed to a "good death". Factors associated with reluctance to receive prolonged treatment were female sex (adjusted odds ratio (AOR 1.39), being in the clinical years of training (AOR 1.92), self-rated good health (AOR 1.45), and prior experience of watching someone dying (AOR 1.61). Enrollment in Srinagarind medical school (AOR 2.05), being a clinical student (AOR1.91), and being dissatisfied with life (AOR 1.78) were independent factors related to preference for home death.

CONCLUSIONS

Most medical students signified understanding of concepts of geriatric palliative care but felt that they had insufficient knowledge in this area. Multiple factors related to decision regarding the care that was required were identified. Medical schools should consider this information to improve geriatric palliative medical education in undergraduate training.

摘要

背景

关于医学生对临终老年人意愿的看法，目前仅有少数研究。更好地了解学生对这一主题的看法有助于改善姑息治疗教育。本研究的目的是探讨医学生对“善终”的看法，并展示与老年患者必要护理决策相关的因素。

方法

这是一项横断面研究。2017 年 9 月至 2018 年 2 月，我们向泰国两所医学院（Siriraj 和 Srinagarind 医院）的所有医学生发放了一份问卷，要求他们根据老年人的想法和对临终关怀的偏好来回答问题。收集并分析了匿名问卷。

结果

共收回 2990 份调查中的 1029 份（34.4%）。少数六年级医学生认为自己对姑息治疗有足够的了解（11.3%）。根据调查，有意愿满足精神需求和让亲人在场是“善终”的最重要条件。与不愿接受长期治疗相关的因素包括女性（调整后的优势比（AOR）1.39）、处于临床培训年限（AOR 1.92）、自我评估健康状况良好（AOR 1.45）和有目睹他人死亡的经历（AOR 1.61）。入读 Srinagarind 医学院（AOR 2.05）、是临床学生（AOR 1.91）和对生活不满意（AOR 1.78）是与选择在家中死亡相关的独立因素。