香港急诊医生提供姑息治疗和临终关怀的态度和教育需求：基于自我报告研究的横断面分析。
Attitudes and educational needs of emergency doctors providing palliative and end-of-life care in Hong Kong: a cross-sectional analysis based on a self-report study.
机构信息
Accident and Emergency Department, North Lantau Hospital, 8 Chung Yan Road, Tung Chun, Lantau, Hong Kong.
Fong Tam Yuen Leung Emergency Medicine Centre, The Chinese University of Hong Kong Medical Centre, 9 Chak Cheung Street, Shatin, New Territories, Hong Kong.
出版信息
BMC Palliat Care. 2021 Mar 23;20(1):48. doi: 10.1186/s12904-021-00742-1.
BACKGROUND
Due to the ageing population in Hong Kong, the importance and need of palliative care and end-of-life (EOL) care are coming under the spotlight. The objectives of this study were to evaluate the attitudes of emergency doctors in providing palliative and EOL care in Hong Kong, and to investigate the educational needs of emergency doctors in these areas.
METHODS
A questionnaire was used to study the attitudes of ED doctors of six different hospitals in Hong Kong. The questionnaire recorded the attitudes of the doctors towards the role of palliative and EOL care in EDs, the specific obstacles faced, their comfort level and further educational needs in providing such care. The attitudes of emergency doctors of EDs with EOL care services were compared with those of EDs without such services.
RESULTS
In total, 145 emergency doctors completed the questionnaire, of which 60 respondents were from EDs with EOL care services. A significant number of participants recognized that the management of the dying process was essential in ED. Providing palliative and EOL care is also accepted as an important competence and responsibility, but the role and priority of palliative and EOL care in ED are uncertain. Lack of time and access to palliative care specialists/ teams were the major barriers. Doctors from EDs with EOL care services are more comfortable in providing such care and discuss it with patients and their relatives. Further educational needs were identified, including the management of physical complaints, communication skills, and EOL care ethics.
CONCLUSIONS
The study identified obstacles in promoting palliative and EOL care in the EDs Hong Kong. With the combination of elements of routine ED practice and a basic palliative medicine skill set, it would promote the development of palliative and EOL care in Emergency Medicine in the future.
背景
由于香港人口老龄化，缓和医疗和临终关怀的重要性和必要性日益受到关注。本研究旨在评估香港急诊医生提供缓和医疗和临终关怀的态度，并调查他们在这些领域的教育需求。
方法
本研究使用问卷对香港六家不同医院的急诊医生进行了调查。问卷记录了医生对急诊部门提供缓和医疗和临终关怀的角色的态度、面临的具体障碍、提供此类护理的舒适度以及进一步的教育需求。比较了具有临终关怀服务的急诊科医生和没有临终关怀服务的急诊科医生的态度。
结果
共有 145 名急诊医生完成了问卷，其中 60 名来自具有临终关怀服务的急诊科。相当多的参与者认识到在急诊科管理临终过程至关重要。提供缓和医疗和临终关怀也被认为是一项重要的能力和责任，但在急诊科，缓和医疗和临终关怀的角色和优先级不确定。缺乏时间和获得缓和医疗专家/团队的机会是主要障碍。具有临终关怀服务的急诊科的医生在提供此类护理方面更舒适，并与患者及其家属讨论。确定了进一步的教育需求，包括身体投诉的管理、沟通技巧和临终关怀伦理。
结论
本研究确定了在香港急诊科推广缓和医疗和临终关怀的障碍。结合常规急诊科实践的要素和基本的姑息医学技能集，将有助于未来在急诊医学中发展缓和医疗和临终关怀。
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