Faculty of Medicine, University of Cantabria, 39005 Santander, Spain.
Servicio de Medicina Intensiva, Marqués de Valdecilla University Hospital, 39008 Santander, Spain.
Int J Environ Res Public Health. 2022 Jun 28;19(13):7901. doi: 10.3390/ijerph19137901.
End-of-life care and the limitation of therapeutic effort are among the most controversial aspects of medical practice. Many subjective factors can influence decision-making regarding these issues. The Q methodology provides a scientific basis for the systematic study of subjectivity by identifying different thought patterns. This methodology was performed to find student profiles in 143 students at Cantabria University (Spain), who will soon deal with difficult situations related to this topic. A chi-square test was used to compare proportions. We obtained three profiles: the first seeks to ensure quality of life and attaches great importance to the patient's wishes; the second prioritizes life extension above anything else; the third incorporates the economic perspective into medical decision-making. Those who had religious beliefs were mostly included in profile 2 (48.8% vs. 7.3% in profile 1 and 43.9% in profile 3), and those who considered that their beliefs did not influence their ethical principles, were mainly included in profile 3 (48.5% vs. 24.7% in profile 1 and 26.8% in profile 2). The different profiles on end-of-life care amongst medical students are influenced by personal factors. Increasing the clinical experience of students with terminally ill patients would contribute to the development of knowledge-based opinion profiles and would avoid reliance on personal experiences.
生命终末期关怀和治疗限制是医学实践中最具争议的方面之一。许多主观因素会影响这些问题的决策。Q 方法为系统研究主观性提供了科学依据,通过确定不同的思维模式来实现。本研究采用 Q 方法对西班牙坎塔布里亚大学的 143 名学生(即将面临与该主题相关的困难情况)进行了学生特征分析。采用卡方检验比较比例。我们得到了三个特征:第一个特征是努力确保生活质量并高度重视患者的意愿;第二个特征是优先延长生命;第三个特征是将经济观点纳入医疗决策。有宗教信仰的人主要集中在特征 2 中(48.8%比特征 1 中的 7.3%和特征 3 中的 43.9%),那些认为自己的信仰不会影响自己的伦理原则的人主要集中在特征 3 中(48.5%比特征 1 中的 24.7%和特征 2 中的 26.8%)。医学生对生命终末期关怀的不同特征受到个人因素的影响。增加学生与绝症患者的临床经验将有助于形成基于知识的观点特征,并避免依赖个人经验。