School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan.
Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan 33301, Taiwan.
Int J Environ Res Public Health. 2022 Mar 24;19(7):3884. doi: 10.3390/ijerph19073884.
This study was designed to investigate healthcare providers' knowledge of palliative care and perceptions of palliative care barriers before and after promoting the Patient Autonomy Act (PAA). A convenience sample was recruited, including 277 healthcare providers in 2013 and 222 healthcare providers in 2018. Multivariate linear regression analyses were used to identify predictors of knowledge of and perceived barriers to palliative care. A principal component analysis was carried out to identify the most appropriate factorial structure for the contents of knowledge and perceived barriers to palliative care. Three factors related to knowledge of palliative care were identified in both 2013 and 2018 data: 'policy, regulation, and promotion', 'philosophy and treatments', and 'myths and misunderstandings'. Study findings for the two periods were similar. As for barriers to providing palliative care, three factors were identified for 2013: 'quality care', 'difficulties' and 'communication', and for 2018, 'information', 'attitudes' and 'quality care' were identified. Study findings differed between the two periods. Policies can better reinforce mitigating strategies-including opportunities for education, shared decision making, and changes in institutions and care systems. Additionally, assessing barriers creates important opportunities for further research to address the most critical aspects in improving end-of-life care for patients and their families.
这项研究旨在调查医疗保健提供者在推广《患者自主法案》（PAA）前后对姑息治疗的知识和对姑息治疗障碍的看法。采用便利抽样法招募了 277 名 2013 年和 222 名 2018 年的医疗保健提供者。采用多元线性回归分析来确定对姑息治疗的知识和感知障碍的预测因素。采用主成分分析来确定姑息治疗知识和感知障碍内容的最合适的因子结构。在 2013 年和 2018 年的数据中，确定了与姑息治疗知识相关的三个因素：“政策、法规和推广”、“哲学和治疗”以及“神话和误解”。两个时期的研究结果相似。至于提供姑息治疗的障碍，2013 年确定了三个因素：“优质护理”、“困难”和“沟通”，而 2018 年则确定了“信息”、“态度”和“优质护理”。两个时期的研究结果存在差异。政策可以更好地加强缓解策略，包括教育机会、共同决策以及机构和护理系统的变革。此外，评估障碍为进一步研究提供了重要机会，以解决改善患者及其家属临终关怀的最关键方面。
