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随机应变:对早期采用医疗协助死亡服务的提供者的知识获取经历的定性研究。

Winging it: a qualitative study of knowledge-acquisition experiences for early adopting providers of medical assistance in dying.

作者信息

Winters Janine Penfield, Pickering Neil, Jaye Chrystal

机构信息

Bioethics Centre, University of Otago, 71 Frederick Street, North Dunedin, Dunedin 9010, New Zealand.

Bioethics Centre, University of Otago, Dunedin, New Zealand.

出版信息

Palliat Care Soc Pract. 2022 Jun 13;16:26323524221103889. doi: 10.1177/26323524221103889. eCollection 2022.

Abstract

BACKGROUND

Medical Assistance in Dying (MAID) was legalized in Canada without a designated period for implementation. Providers did not have access to customary alternatives for training and mentorship during the first 1-3 years after legalization.

OBJECTIVE

To report on how doctors prepared for their first provision of MAID in the early period after legalization in Canada.

DESIGN

Qualitative research design within an interpretive phenomenological theoretical framework. We asked participants to describe their experiences preparing for first MAID provision. Analysis of transcripts elicited themes regarding training and information desired by early adopters for provision of newly legalized MAID.

PARTICIPANTS

Twenty-one early adopting physician-providers in five Canadian provinces were interviewed.

RESULTS

Few formal training opportunities were available. Many early-adopting providers learned about the procedure from novel sources using innovative methods. They employed a variety of strategies to meet their needs, including self-training and organizing provider education groups. They acknowledged and reflected on uncertainty and knowledge gained from unexpected experiences and missteps. Key phrases from participants indicated a desire for early training and mentorship.

LIMITATIONS

This study included only the perspective of physicians who were providers of MAID. It does not address the training needs for all health practitioners who receive requests for assisted death nor report the patient/family experience.

CONCLUSION

The Canadian experience demonstrates the importance of establishing accessible guidance and training opportunities for providers at the outset of implementation of newly legalized assisted dying.

摘要

背景

加拿大的医疗协助死亡(MAID)合法化时没有设定特定的实施期限。在合法化后的最初1至3年里,提供者无法获得常规的培训和指导替代方案。

目的

报告加拿大MAID合法化初期医生首次提供MAID的准备情况。

设计

在解释性现象学理论框架内进行定性研究设计。我们要求参与者描述他们首次提供MAID的准备经历。对访谈记录的分析引出了早期采用者在提供新合法化的MAID时所需培训和信息的主题。

参与者

对加拿大五个省份的21名早期采用的医生提供者进行了访谈。

结果

几乎没有正式的培训机会。许多早期采用的提供者通过新颖的来源和创新的方法了解该程序。他们采用了多种策略来满足自身需求,包括自我培训和组织提供者教育小组。他们承认并反思了不确定性以及从意外经历和失误中获得的知识。参与者的关键表述表明他们渴望早期培训和指导。

局限性

本研究仅包括MAID提供者医生的观点。它没有涉及所有收到协助死亡请求的卫生从业者的培训需求,也没有报告患者/家庭的经历。

结论

加拿大的经验表明,在新合法化的协助死亡实施之初,为提供者建立可获取的指导和培训机会非常重要。

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