Department of Internal Medicine, Singapore General Hospital, Outram Rd, Singapore, 169608, Singapore.
Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
BMC Palliat Care. 2021 Jun 30;20(1):101. doi: 10.1186/s12904-021-00787-2.
The extension of palliative care services to meet the needs of patients with chronic non-malignant life-limiting conditions faces misconceptions amongst healthcare professionals. A study of prevailing perceptions of healthcare professionals on this wider palliative care service was thus conducted to identify current obstacles, guide the education of local healthcare professionals and improve service accessibility.
A cross-sectional study was carried out at the Singapore General Hospital. An anonymised and close-ended online questionnaire was disseminated to 120 physicians and 500 nurses in the Department of Internal Medicine. The online survey tool focused on participant demographics; perceptions of palliative care and its perceived benefits; roles and indications; and attitudes and behaviours towards palliative care referrals.
Forty four physicians and 156 nurses suggested that care of terminally ill patients with chronic non-malignant life-limiting conditions are compromised by concerns over the role of palliative care in non-cancer care and lapses in their prognostication and communication skills. Respondents also raised concerns about their ability to confront sociocultural issues and introduce palliative care services to patients and their families.
Gaps in understanding and the ability of nurses and physicians to communicate end of life issues, introduce palliative care services to patients and their families and confront sociocultural issues suggest the need for a longitudinal training program. With similar concerns likely prevalent in other clinical settings within this island nation, a concerted national education program targeting obstacles surrounding effective palliative care should be considered.
为满足患有慢性非恶性绝症患者的需求而扩展姑息治疗服务面临着医疗保健专业人员的误解。因此，对医疗保健专业人员对这种更广泛的姑息治疗服务的普遍看法进行了研究，以确定当前的障碍，指导当地医疗保健专业人员的教育，并提高服务的可及性。
在新加坡总医院进行了一项横断面研究。向内科部门的 120 名医生和 500 名护士分发了匿名和封闭式在线问卷。在线调查工具主要关注参与者的人口统计学特征；对姑息治疗及其预期效益的看法；角色和适应症；以及对姑息治疗转诊的态度和行为。
44 名医生和 156 名护士认为，对患有慢性非恶性绝症的终末期患者的护理受到对姑息治疗在非癌症护理中的作用的担忧以及对预后和沟通技巧的失误的影响。受访者还对自己处理社会文化问题以及向患者及其家属介绍姑息治疗服务的能力表示担忧。
护士和医生对了解姑息治疗服务的不足以及他们沟通临终问题、向患者及其家属介绍姑息治疗服务和处理社会文化问题的能力存在差距，这表明需要进行纵向培训计划。在这个岛国的其他临床环境中可能也存在类似的问题，因此应考虑针对有效姑息治疗的周边障碍制定全国性教育计划。
