Interdisciplinary Centre for Palliative Medicine, Heinrich-Heine-University Duesseldorf, University Hospital Duesseldorf, Duesseldorf, Germany.
Centre of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Cologne, Germany.
BMC Med Educ. 2024 Mar 18;24(1):279. doi: 10.1186/s12909-024-05269-6.
The desire to die can occur in palliative care patients with a prevalence of up to 22%. Not every desire to die is accompanied by a pressure to act, but usually by a burden that can arise from various factors. To address this burden appropriately, health care workers should be trained. Based on an evaluated course on handling the desire to die, an elective course for medical students was developed and evaluated. In order to identify the impact of the elective course's content, a comparison of attitudes towards assisted dying with two other participant groups was conducted. Therefore, three questions from the evaluation of the elective course were used.
Online evaluation of the elective and questions addressing attitude were assessed using a five-point Likert scale. The specific outcome-based assessment was determined using the Comparative Self-Assessment Gain. The main participant group (group 1) were students who took the elective. The additional survey on attitudes towards assisted dying included undergraduate medical students who had taken compulsory palliative care courses (group 2) and physicians who had taken an introductory course in intensive care or emergency medicine (group 3).
Group 1 (n = 13, response rate rr = 86.7%) was very satisfied with the blended learning format (100%) and the course itself (100%). They were able to deepen their knowledge (81.0%) and train skills (71.2%) through the course. In the additional surveys, there were 37 students in group 2 (rr = 66.1%) and 258 physicians in group 3 (rr = 73.6%). Willingness to assist with or accompany the various options for assisted dying varied according to the type of assistance. Among the participants, it can be summarised that the highest willingness was shown by the students of group 2 followed by the physicians of group 3 and the students of group 1.
A course on handling the desire to die of palliative patients can deepen knowledge and train communication skills and thus support self-confidence. Dealing with the background of the desire to die, knowledge about assisted dying, but also one's own attitudes and responsibilities can influence the attitude towards assisted dying.
在姑息治疗患者中,想死的愿望的发生率高达 22%。并非每个想死的愿望都伴随着行动的压力,但通常伴随着各种因素引起的负担。为了适当处理这种负担,医护人员应该接受培训。基于对处理想死的愿望的评估课程,为医学生开发并评估了一门选修课程。为了确定选修课程内容的影响,对三个参与者群体的辅助死亡态度进行了比较。因此,使用了选修课程评估中的三个问题。
使用五点李克特量表在线评估选修课程和解决态度的问题。基于比较自我评估增益的特定基于结果的评估。主要参与者群体(第 1 组)是参加选修课程的学生。关于辅助死亡态度的额外调查包括已经参加了强制性姑息治疗课程的本科医学生(第 2 组)和已经参加了重症监护或急诊医学入门课程的医生(第 3 组)。
第 1 组(n=13,响应率 rr=86.7%)对混合学习格式(100%)和课程本身(100%)非常满意。他们能够通过课程加深知识(81.0%)和培养技能(71.2%)。在额外的调查中,第 2 组有 37 名学生(rr=66.1%),第 3 组有 258 名医生(rr=73.6%)。根据辅助类型,对辅助各种辅助死亡选项的意愿各不相同。在参与者中,可以总结出第 2 组的学生表现出最高的意愿,其次是第 3 组的医生和第 1 组的学生。
姑息患者处理想死的愿望的课程可以加深知识和培养沟通技巧,从而增强信心。处理想死的愿望的背景、辅助死亡的知识,以及自己的态度和责任,都会影响对辅助死亡的态度。