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老年病学教育计划对急诊医师的影响:一项混合方法研究。

Effects of a geriatric education program for emergency physicians: a mixed-methods study.

机构信息

Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Radboud Institute for Health Sciences, IQ Health Care, Nijmegen, The Netherlands.

出版信息

Health Educ Res. 2020 Jun 1;35(3):216-227. doi: 10.1093/her/cyaa007.

Abstract

Emergency physicians (EPs) often regard care for older adults as complex, while they lack sufficient geriatric skills. This study evaluates the effect of a geriatric education program on EPs' geriatric knowledge, attitude and medical practice when treating older adults. A mixed-methods study was performed on EPs from two Dutch hospitals. Effects were measured by pre-post tests of EPs' (n = 21) knowledge of geriatric syndromes and attitudes toward older adults, and by a retrospective pre-post analysis of 100 records of patients aged 70 years or more. Six EPs were purposively sampled and interviewed after completion of the education program. The program significantly improved EPs' geriatric knowledge. EPs indicated that the program improved their ability and attentiveness to recognize frailty and geriatric syndromes. The program also significantly improved EPs' attention for the older patient's social history and circumstances (P = 0.04) but did not have a significant effect on medical decision making. EPs valued especially the case-based teaching and indicated that the interactive setting helped them to better understand and retain knowledge. Combined quantitative and qualitative data suggest that EPs benefit from geriatric emergency teaching. Future enhancement and evaluation of the geriatric education program is needed to confirm benefits to clinical practice and patient outcomes.

摘要

急诊医生(EPs)通常认为老年人的护理很复杂,而他们缺乏足够的老年医学技能。本研究评估了老年医学教育计划对急诊医生治疗老年人时的老年医学知识、态度和医疗实践的影响。对来自荷兰两家医院的 21 名急诊医生进行了一项混合方法研究。通过急诊医生(n=21)对老年综合征的知识和对老年人的态度的预-后测试,以及对 100 名 70 岁及以上患者病历的回顾性预-后分析来衡量效果。在完成教育计划后,有 6 名急诊医生被有目的地抽样并进行了访谈。该计划显著提高了急诊医生的老年医学知识。急诊医生表示,该计划提高了他们识别脆弱和老年综合征的能力和关注度。该计划还显著提高了急诊医生对老年患者社会史和环境的关注(P=0.04),但对医疗决策没有显著影响。急诊医生特别重视基于案例的教学,并表示互动式教学环境有助于他们更好地理解和掌握知识。定量和定性数据的综合结果表明,急诊医生从老年急诊教学中受益。需要进一步加强和评估老年医学教育计划,以确认其对临床实践和患者结局的益处。

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