Kazazian Karnig, Chum Marvin, Gofton Teneille E
Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Canada.
Division of Neurology, Department of Medicine, St. Joseph's Healthcare Hamilton, McMaster University, Burlington, Canada.
Can J Neurol Sci. 2023 Jan;50(1):83-88. doi: 10.1017/cjn.2021.511. Epub 2022 Jan 3.
To identify sources of distress experienced by trainees when providing neuropalliative care and to explore the perceived and unperceived educational needs of trainees learning to deliver neuropalliative care.
This study is a post hoc analysis of a qualitative investigation performed at a single Canadian academic center with active clinical services in palliative medicine, neurology, and neurosurgery. Grounded theory methodology was used to explore trainees' perspectives when learning neuropalliative care. This study used focus groups, using open-ended questions, to elicit participants' experiences providing neuropalliative care as well as to explore the challenges in neuropalliative care.
Qualitative analysis identified multiple sources of distress for trainees in neuropalliative care and broad themes emerged: 1) a , 2) the of learning neuropalliative care, and 3) in neuropalliative care.
Our results suggest that palliative neurology curricula should focus not only on symptom management but also on strategies for improving communication about prognosis and managing clinical uncertainty. Improving trainee comfort and confidence in neuropalliative care throughout the illness trajectory may alleviate sources of distress during training and increase quality of care.
确定实习生在提供神经姑息治疗时所经历的困扰来源，并探索学习提供神经姑息治疗的实习生所感知到的和未被感知到的教育需求。
本研究是对在加拿大一个单一学术中心进行的定性调查的事后分析，该中心在姑息医学、神经病学和神经外科方面提供积极的临床服务。扎根理论方法用于探索实习生在学习神经姑息治疗时的观点。本研究采用焦点小组，通过开放式问题，引出参与者提供神经姑息治疗的经历以及探索神经姑息治疗中的挑战。
定性分析确定了实习生在神经姑息治疗中存在多种困扰来源，并出现了广泛的主题：1）一个，2）学习神经姑息治疗的，3）神经姑息治疗中的。
我们的结果表明，姑息性神经病学课程不仅应关注症状管理，还应关注改善关于预后的沟通和管理临床不确定性的策略。在整个疾病轨迹中提高实习生对神经姑息治疗的舒适度和信心，可能会减轻培训期间的困扰来源，并提高护理质量。
