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多专业专家组视角下的姑息治疗中医师的必备能力:一项定性研究。

The required competencies of physicians within palliative care from the perspectives of multi-professional expert groups: a qualitative study.

机构信息

Department of Social and Health Care, VAMK University of Applied Sciences, Wolffintie 27-31, 65200, Vaasa, Finland.

School of Health, Kajaani University of Applied Sciences, PL 52, Ketunpolku 4, 87101, Kajaani, Finland.

出版信息

BMC Palliat Care. 2020 May 9;19(1):65. doi: 10.1186/s12904-020-00566-5.

Abstract

BACKGROUND

Although statements on the competencies required from physicians working within palliative care exist, these requirements have not been described within different levels of palliative care provision by multi-professional workshops, comprising representatives from working life. Therefore, the aim of this study was to describe the competencies required from physicians working within palliative care from the perspectives of multi-professional groups of representatives from working life.

METHODS

A qualitative approach, using a workshop method, was conducted, wherein the participating professionals and representatives of patient organizations discussed the competencies that are required in palliative care, before reaching and documenting a consensus. The data (n = 222) was collected at workshops held in different parts of Finland and it was analyzed using a qualitative content analysis method.

RESULTS

The description of the competencies required of every physician working within palliative care at the general level included 13 main categories and 50 subcategories in total. 'Competence in advanced care planning and decision-making' was the main category which was obtained from the highest number of reduced expressions from the original data (f = 125). Competence in social interactions was another strong main category (f = 107). In specialist level data, six main categories with 22 subcategories in total were found. 'Competence in complex symptom management' was the main category which was obtained from the biggest number of reduced expressions (f = 46). A notable association between general level and specialist level data was related to networking, since one of the general level categories was 'Competence in consultations and networking' (f = 34) and one of the specialist level categories was 'Competence to offer consultative and educational support to other professionals' (f = 30). Moreover, part of the specialist level results were subcategories which belonged to the main categories produced from the general level data.

CONCLUSIONS

The competencies described in this study emphasize decision-making, social interactions and networking. It is important to listen to the voices of the working-life representatives when planning curricula. Moreover, the views of the working-life representatives inform how the competencies gained during their education meet the challenges of the ordinary work.

摘要

背景

尽管有关于姑息治疗医生所需能力的陈述,但这些要求并未在多专业工作坊(包括工作场所代表)所提供的不同姑息治疗水平中描述。因此,本研究的目的是从工作场所多专业代表团体的角度描述姑息治疗医生所需的能力。

方法

采用工作坊方法进行定性研究,参与的专业人员和患者组织代表讨论了姑息治疗所需的能力,然后达成共识并记录下来。数据(n=222)是在芬兰不同地区举办的工作坊中收集的,采用定性内容分析法进行分析。

结果

在一般水平上,每位姑息治疗医生所需的能力描述包括 13 个主要类别和 50 个子类别。“高级关怀计划和决策能力”是主要类别,从原始数据中获得了最多的简化表达(f=125)。社会互动能力是另一个强有力的主要类别(f=107)。在专家水平的数据中,共发现了 6 个主要类别和 22 个子类别。“复杂症状管理能力”是主要类别,获得了最多的简化表达(f=46)。一般水平和专家水平数据之间存在显著关联,与网络有关,因为一般水平的一个类别是“咨询和网络能力”(f=34),专家水平的一个类别是“为其他专业人员提供咨询和教育支持的能力”(f=30)。此外,专家水平的部分结果是属于一般水平数据产生的主要类别的子类别。

结论

本研究描述的能力强调决策、社会互动和网络。在规划课程时,听取工作场所代表的意见很重要。此外,工作场所代表的观点告知了他们在教育中获得的能力如何应对日常工作中的挑战。

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