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美国物理医学与康复住院医师培训项目中的姑息治疗教育:当前实践、感知需求和障碍

Palliative Care Education in US Physical Medicine and Rehabilitation Residency Programs: Current Practices, Perceived Needs, and Barriers.

作者信息

Yeh Jonathan C, Ambady Leena, Lewis Ryan, Mehta Ambereen K, Asher Arash, Raj Vishwa S, Engle Jessica P

机构信息

Section of Palliative Care, Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Harvard Medical School, Boston, Massachusetts, USA.

出版信息

J Palliat Med. 2023 Aug;26(8):1128-1132. doi: 10.1089/jpm.2022.0606. Epub 2023 Jun 16.

Abstract

Physical medicine and rehabilitation (PM&R) clinicians commonly care for patients with serious illness/injury and would benefit from primary palliative care (PC) training. To assess current practices, attitudes, and barriers toward PC education among U.S. PM&R residencies. This is a cross-sectional study utilizing an electronic 23-question survey. Subjects were program leaders from U.S. PM&R residency programs. Twenty-one programs responded (23% response). Only 14 (67%) offered PC education through lectures, elective rotations, or self-directed reading. Pain management, communication, and nonpain symptom management were identified as the most important PC domains for residents. Nineteen respondents (91%) felt residents would benefit from more PC education, but only five (24%) reported undergoing curricular change. Lack of faculty availability/expertise and teaching time were the most endorsed barriers. PC education is heterogeneous across PM&R programs despite its perceived value. PC and PM&R educators can collaborate to build faculty expertise and integrate PC principles into existing curricula.

摘要

物理医学与康复(PM&R)临床医生通常负责治疗重症/重伤患者,接受初级姑息治疗(PC)培训将对他们有所帮助。为评估美国物理医学与康复住院医师培训项目目前在PC教育方面的实践、态度和障碍。这是一项采用23个问题的电子调查问卷的横断面研究。研究对象为美国物理医学与康复住院医师培训项目的项目负责人。21个项目做出了回应(回应率为23%)。只有14个项目(67%)通过讲座、选修轮转或自主阅读提供PC教育。疼痛管理、沟通和非疼痛症状管理被确定为住院医师最重要的PC领域。19名受访者(91%)认为住院医师将从更多的PC教育中受益,但只有5个项目(24%)报告课程有变化。师资不足/专业知识缺乏和教学时间是最常被提及的障碍。尽管PC教育具有公认的价值,但在物理医学与康复项目中其情况参差不齐。PC和物理医学与康复教育工作者可以合作,培养师资专业知识,并将PC原则纳入现有课程。

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