Faculty of Arts and Science, 7938University of Toronto, Toronto, Ontario, Canada.
Institute for Life Course and Aging, Factor-Inwentash Faculty of Social Work, 7938University of Toronto, Toronto, Ontario, Canada.
J Palliat Care. 2021 Jul;36(3):151-156. doi: 10.1177/0825859719865548. Epub 2019 Aug 14.
With the legalization of medical assistance in dying (MAiD) in Canada, physicians and nurse practitioners now have another option within their scope of practice to consider alongside hospice palliative care (HPC) to support the patient and family regardless of their choice toward natural or medically assisted death. To elucidate insights and experiences with MAiD since its inception and to help adjust to this new end-of-life care environment, the membership of the Canadian Hospice Palliative Care Association (CHPCA) was surveyed.
The CHPCA developed and distributed a 16-item survey to its membership in June 2017, one year following the legalization of MAiD. Data were arranged in Microsoft® Excel and open-ended responses were analyzed thematically using NVivo 12 software.
From across Canada, 452 responses were received (response rate: 15%). The majority of individuals worked as nurses (n = 161, 33%), administrators (n = 79, 16%), volunteers (n = 76, 16%) and physicians (n = 56, 11%). Almost 75% (n = 320) of all respondents indicated that they had experienced a patient in their program who had requested MAiD. Participants expressed dissatisfaction with the current psychological and professional support being provided by their health care organization and Ministry of Health - during and after the MAiD procedure.
The new complexities of MAiD present unique challenges to those working in the health-care field. There needs to be an increased focus on educating/training providers as without proper support, health-care workers will be unable to perform to their full potential/scope of practice while also providing patients with holistic and accessible care.
随着加拿大安乐死合法化,医生和护士从业者现在在他们的实践范围内有了另一种选择,除了临终关怀(HPC)之外,还可以考虑支持患者及其家属,无论他们选择自然死亡还是医疗辅助死亡。为了阐明自安乐死合法化以来的见解和经验,并帮助适应这种新的临终关怀环境,加拿大临终关怀协会(CHPCA)对其成员进行了调查。
CHPCA 在 2017 年 6 月,即安乐死合法化一年后,为其成员开发并分发了一份 16 项的调查问卷。数据在 Microsoft® Excel 中进行整理,使用 NVivo 12 软件对开放式回答进行主题分析。
来自加拿大各地的 452 人做出了回应(回应率:15%)。大多数人从事护士工作(n=161,33%)、行政人员(n=79,16%)、志愿者(n=76,16%)和医生(n=56,11%)。几乎 75%(n=320)的受访者表示,他们在自己的项目中遇到过要求安乐死的患者。参与者对他们所在的医疗机构和卫生部目前提供的心理和专业支持表示不满——在安乐死程序期间和之后。
安乐死的新复杂性给医疗保健领域的工作者带来了独特的挑战。需要更加注重教育/培训提供者,因为如果没有适当的支持,医疗保健工作者将无法充分发挥潜力/实践范围,同时为患者提供全面和可及的护理。