Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany.
Department of Public Health and Health Care, Yerevan State Medical University, Yerevan, Armenia.
BMC Palliat Care. 2022 Apr 20;21(1):53. doi: 10.1186/s12904-022-00938-z.
Due to developing demographic changes, including an aging society and the increasing prevalence of non-communicable diseases, Palliative Care is increasingly highlighted as a universal healthcare need. The need for Palliative Care in Armenia is set against the context of an underdeveloped healthcare system. Further, the absence of palliative medicine within medical education, particularly undergraduate education in Armenia presents a major barrier to improving care. This research aimed to assess the perception of young Armenian physicians' understanding of Palliative Care, its perceived status in Armenia and the experience and influence of any engaged Palliative Care education.
Twenty Armenian first-year residents with different specializations were interviewed July and September 2016 regarding: understanding/knowledge, experiences, perceived competence, and expectations of Palliative Care and Palliative Care education. The transcripts from these semi-structured interviews were analyzed using Qualitative Content Analysis.
Participants perceived that Armenia's health care system lacked sufficient Palliative Care and Palliative Care education. Although elements of Palliative Care were included in different specialty teaching, this provided just a partial understanding of typical Palliative Care patients/symptoms, approaches to holistic care, and crucially key communication skills. Challenges noted by participants in caring for Palliative Care patients included emotional difficulties, communication of diagnosis/prognosis, uninformed patients and concerns for patients, families, and physicians. Self-confidence in caring for patients with incurable illness varied. Participants hoped for increasing availability and accessibility of Palliative Care, and extension of clinical education in Palliative Care at all levels (undergraduate, postgraduate, specialization).
Absence of training has resulted in misconceptions and ignorance of common concepts and practices in Palliative Care. Palliative Care education needs to be systematically developed and integrated into clinical training within Armenia. This research may provide a rallying call for changes within the core curricula in Armenia and may also encourage collaborative development in associated countries of the Caucasus region.
由于人口结构的变化，包括老龄化社会和非传染性疾病的日益流行，缓和医疗越来越被视为一种普遍的医疗需求。亚美尼亚需要缓和医疗，这是在医疗体系欠发达的背景下提出的。此外，亚美尼亚的医学教育中没有缓和医学，特别是本科教育，这是改善医疗服务的主要障碍。本研究旨在评估年轻亚美尼亚医生对缓和医疗的理解、对其在亚美尼亚的地位的看法，以及他们所经历的缓和医疗教育及其影响。
2016 年 7 月至 9 月，对 20 名不同专业的亚美尼亚一年级住院医师进行了访谈，内容涉及：对缓和医疗的理解/知识、经验、感知能力、对缓和医疗和缓和医疗教育的期望。对这些半结构化访谈的记录进行了定性内容分析。
参与者认为亚美尼亚的医疗保健系统缺乏足够的缓和医疗和缓和医疗教育。尽管缓和医疗的元素包含在不同的专业教学中，但这只是对典型的缓和医疗患者/症状、整体护理方法的部分理解，而且关键的沟通技巧也没有涉及。参与者在照顾缓和医疗患者时遇到的挑战包括情绪困难、诊断/预后的沟通、患者不知情、患者、家属和医生的担忧。对照顾绝症患者的信心因人而异。参与者希望增加缓和医疗的可及性和可及性，并在各级（本科、研究生、专科）临床教育中扩大缓和医疗教育。
缺乏培训导致对缓和医疗的常见概念和实践存在误解和无知。亚美尼亚需要系统地发展缓和医疗教育，并将其纳入临床培训。本研究可能会呼吁亚美尼亚的核心课程做出改变，也可能会鼓励在高加索地区的相关国家进行合作发展。
