Wong Kan Yin, Li Wai Tak Victor, Yiu Pui Yu, Tong Tsz Kiu, Ching On Hang, Leung Lok Yin, Cheung Tsz Yau, Chan Sze Chai, Law Hoi Ying, Cheng Cheuk Hei
School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
Med Sci Educ. 2020 Feb 3;30(1):445-455. doi: 10.1007/s40670-020-00928-x. eCollection 2020 Mar.
Since insufficient education has partially contributed to challenges in providing pediatric palliative care (PPC), a cross-sectional questionnaire study was conducted to explore the knowledge, attitudes, and educational needs of preclinical medical and nursing students in Hong Kong.
Pretested self-administered 44-item questionnaires with written informed consent were distributed to 241 medical and nursing students at Li Ka Shing Faculty of Medicine, the University of Hong Kong, between February and March 2019. This questionnaire covered eleven categories related to participants' knowledge of and attitudes towards PPC. A convenience sampling method was used. Data analysis was performed with descriptive statistics, chi-squared, and Fisher's exact test.
Only 38.3% of participants had heard of PPC before, but 73.5% advocated for its local commencement. A large number, with more in nursing, misunderstood fundamental palliative concepts and pain assessment methods. Many reported that undergraduate curricula should include PPC since they were not prepared to deal and cope with dying children. More medical students identified multidisciplinary approaches in PPC while less believed that they were mentally prepared to discuss death and dying. The majority indicated family as the final decision maker, even for teenage patients. Although a large proportion agreed that PPC should be delivered at home since the diagnosis of a life-limiting illness, only a few were aware of the suggested referral structure.
Most healthcare students were supportive of PPC despite their limited exposure. PPC education on palliative principles, pain management, multidisciplinary approaches, and emotional coping skills is needed and welcomed among students.
由于教育不足在一定程度上导致了儿科姑息治疗(PPC)面临挑战,因此开展了一项横断面问卷调查研究,以探讨香港临床前医学和护理专业学生的知识、态度及教育需求。
2019年2月至3月期间,在获得书面知情同意后,向香港大学李嘉诚医学院的241名医学和护理专业学生发放了经预测试的44项自填式问卷。该问卷涵盖了与参与者对PPC的知识和态度相关的11个类别。采用便利抽样方法。数据分析采用描述性统计、卡方检验和Fisher精确检验。
只有38.3%的参与者之前听说过PPC,但73.5%的人主张在当地开展PPC。很多人,尤其是护理专业的学生,对基本的姑息治疗概念和疼痛评估方法存在误解。许多人报告说本科课程应该包括PPC,因为他们没有准备好应对濒死儿童的情况。更多的医学生认同PPC中的多学科方法,而较少有人认为自己在心理上准备好讨论死亡。大多数人表示即使是青少年患者,家庭也是最终决策者。尽管很大一部分人同意自确诊为危及生命的疾病以来就应在家中提供PPC,但只有少数人了解建议的转诊结构。
尽管接触有限,但大多数医护专业学生支持PPC。学生们需要并欢迎开展有关姑息治疗原则、疼痛管理、多学科方法和情绪应对技巧的PPC教育。