Emergency Department, Cork University Hospital, Cork.
Irish Trainee Emergency Research Network (ITERN).
Eur J Emerg Med. 2023 Aug 1;30(4):267-270. doi: 10.1097/MEJ.0000000000001033. Epub 2023 May 29.
Emergency departments (EDs) are seeing an increase in patients requiring end-of-life (EOL) care. There is paucity of data of attitudes and knowledge of physicians providing EOL care in the ED both internationally and in Ireland.
The aim of this project was to assess the attitudes and knowledge of ED physicians towards EOL care.
This was a cross-sectional electronic survey of ED physicians working in Irish EDs and was facilitated through the Irish Trainee Emergency Research Network over a 6-week period. The questionnaire covered the following domains: demographic data, awareness of EOL Care, views and attitudes towards EOL care.
Of a potential 679 respondents, 441 responses were received, of which 311 (response rate of 44.8%) had fully completed the survey across 23 participant sites. Majority of the respondents were under the age of 35 (62%), were male (58%) and at Senior House Officer level (36%). In terms of awareness, 32% (98) of respondents were not aware of palliative care services in their hospitals while only 29% (91) were aware of national EOL guidance. Fifty-five percent (172) reported commencing EOL care in the ED, however 75.5% (234) respondents reported their knowledge of EOL care to be limited or non-existent. Only 30.2% respondents felt comfortable commencing EOL care in the ED without speciality team input. There appears to be a lack of clarity on the roles and responsibilities of emergency medicine nurses and doctors in the care of the dying patient in ED with only 31.2% (95) being clear on this role. Significant differences were observed associated with clinical experience and physician grade.
This study has highlighted a lack of awareness and knowledge of EOL care particularly amongst less experienced emergency medicine doctors. Formalized training and education programs in the provision of EOL care in the ED will improve comfort levels and knowledge amongst the emergency medicine doctors and improve the quality of care provided.
急诊科（ED）中需要临终关怀（EOL）的患者数量不断增加。在国际上和爱尔兰，关于在急诊科提供 EOL 护理的医生的态度和知识的数据都很少。
本项目旨在评估急诊科医生对 EOL 护理的态度和知识。
这是一项针对在爱尔兰急诊科工作的急诊科医生的横断面电子调查，通过爱尔兰实习急诊研究网络在 6 周内进行。问卷涵盖以下领域：人口统计学数据、对 EOL 护理的认识、对 EOL 护理的看法和态度。
在潜在的 679 名受访者中，有 441 人做出了回应，其中 311 人（回应率为 44.8%）在 23 个参与地点完成了全面调查。大多数受访者年龄在 35 岁以下（62%），为男性（58%），处于住院医师（36%）级别。在意识方面，32%（98 人）的受访者不知道他们所在医院的姑息治疗服务，而只有 29%（91 人）知道国家 EOL 指南。55%（172 人）报告在急诊科开始 EOL 护理，但 75.5%（234 人）的受访者表示他们对 EOL 护理的了解有限或不存在。只有 30.2%的受访者在没有专科团队输入的情况下在急诊科开始 EOL 护理感到舒适。在急诊科，急诊医学护士和医生在临终患者护理中的角色和责任似乎不够明确，只有 31.2%（95 人）对此角色清楚。观察到与临床经验和医生级别相关的显著差异。
本研究表明，特别是在经验较少的急诊医生中，对 EOL 护理的认识和知识不足。在急诊科提供 EOL 护理的规范化培训和教育计划将提高急诊医生的舒适度和知识水平，并提高提供的护理质量。
