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[三级医院急诊医师的姑息治疗认知与能力]

[Cognition and Ability of Emergency Physicians for Palliative Care in Tertiary Hospitals].

作者信息

DU Tie-Kuan, Ning Xiao-Hong, Zhu Hua-Dong, Shi Di, Li Jia-Yi

机构信息

Department of Emergency Medicine,Beijing 100730,China.

Department of Geriatrics,PUMC Hospital,CAMS and PUMC,Beijing 100730,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2021 Aug;43(4):563-570. doi: 10.3881/j.issn.1000-503X.13594.

Abstract

Objective To understand the cognition and related abilities of emergency physicians for palliative care in China. Methods A total of 115 emergency physicians were selected by convenient sampling to conduct a questionnaire survey.The questionnaire included the physicians' basic information,feelings and attitudes towards end-stage patients and their families,cognition of palliative care,and personal ability for palliative care. Results 25.2%,59.1%,and 15.7% of the emergency physicians considered they had "no understanding","partial understanding",and "full understanding" of palliative care,respectively.32(27.8%)physicians participated in palliative care-related lectures and they showed higher self-rated cognition levels(=0.002).Wechat(39.1%),media(36.5%),and word of mouth(33.0%)were the main ways for emergency physicians to acquire the knowledge of palliative care.Among the emergency physicians,68.7% felt "powerless" in the face of end-stage patients,and 60.9% and 59.1% felt tangled and worried about death causing disputes,respectively.The emergency physicians had low self-rated ability in relieving dyspnea after removal of ventilator[3(2,4)]and eliminating the fear of death[3(3,4)].The self-rated cognition level of emergency physicians to palliative care was positively correlated with most of the self-rated ability indexes. Conclusions Lectures have a significant impact on emergency physicians' cognition level of palliative care.Most of the self-rated indexes of palliative care ability are positively correlated with the cognition level of palliative care.In the face of end-stage patients,most of the emergency physicians are powerless,tangled,and worried about disputes,and their self-rated indexes in relieving dyspnea after removal of ventilator and eliminating the fear of death are low,which necessitates relevant training.

摘要

目的 了解我国急诊医师对姑息治疗的认知及相关能力。方法 采用方便抽样法选取115名急诊医师进行问卷调查。问卷内容包括医师的基本信息、对终末期患者及其家属的感受和态度、对姑息治疗的认知以及个人的姑息治疗能力。结果 分别有25.2%、59.1%和15.7%的急诊医师认为自己对姑息治疗“不了解”“部分了解”和“完全了解”。32名(27.8%)医师参加过姑息治疗相关讲座,他们的自评认知水平较高(P = 0.002)。微信(39.1%)、媒体(36.5%)和口碑(33.0%)是急诊医师获取姑息治疗知识的主要途径。在急诊医师中,68.7%面对终末期患者时感到“无力”,60.9%和59.1%分别对死亡引发纠纷感到纠结和担忧。急诊医师在撤机后缓解呼吸困难[3(2,4)]和消除对死亡的恐惧[3(3,4)]方面的自评能力较低。急诊医师对姑息治疗的自评认知水平与大多数自评能力指标呈正相关。结论 讲座对急诊医师的姑息治疗认知水平有显著影响。姑息治疗能力的大多数自评指标与姑息治疗认知水平呈正相关。面对终末期患者,大多数急诊医师感到无力、纠结且担心纠纷,他们在撤机后缓解呼吸困难和消除对死亡恐惧方面的自评指标较低,这需要进行相关培训。

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