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自愿协助死亡:对医疗专业人员的影响。

Voluntary assisted dying: impacts on health professionals.

作者信息

Lamba Geetanjali Tanji, LaBrooy Camille, Lewis Sophie, Olver Ian, Holmes Alexander, Stewart Cameron, Komesaroff Paul

机构信息

Monash University Faculty of Medicine, Nursing and Health Sciences, School of Public Health and Preventive Medicine, Vic, Australia; and Northern Territory Government, PO Box 40596, Casuarina, NT 0811, Australia.

School of Social and Political Sciences, University of Melbourne, Vic, Australia.

出版信息

Aust Health Rev. 2024 Dec;48(6):720-728. doi: 10.1071/AH24142.

Abstract

Objective The introduction and implementation of voluntary assisted dying (VAD) legislation represents a major shift in Australian health policy. Given potential repercussions for health professionals, understanding how they are being affected by this legislation is important to guide future policy and legislative changes. This study aims to explore the perspectives and experiences of Australian health professionals on VAD and compare impacts on those working under different state legislation in Victoria and WA. Methods Data were collected using a cross-sectional survey design, targeting health professionals nationally, primarily doctors and nurses. The survey had closed and open-ended response options, was informed by previous publications and was piloted prior to further roll-out. Recruitment was via professional networks and social media. Quantitative data were descriptively analysed and qualitative data were coded using NVivo and thematically analysed. Results There was a final sample size of 223. Impacts on clinicians identified include inadequate remuneration, a need for ongoing support and the recognition of barriers to mandatory training. Conclusions Impacts on health practitioners, if not addressed, have future implications for workforce sustainability. Increasing numbers of trained VAD practitioners may enable distribution of clinical load and prevent burnout. VAD practitioners are not being appropriately remunerated, which could be addressed by introducing dedicated Medicare Benefits Schedule items for VAD. Attention should also be given to incentivising training, including continuing professional development accreditation and appropriate funding. Strategies to support staff could include debriefing, mentoring, peer support and psychological consultations.

摘要

目的 自愿协助死亡(VAD)立法的引入和实施代表了澳大利亚卫生政策的重大转变。鉴于对卫生专业人员可能产生的影响,了解他们如何受到该立法的影响对于指导未来的政策和立法变革至关重要。本研究旨在探讨澳大利亚卫生专业人员对VAD的看法和经历,并比较维多利亚州和西澳大利亚州不同州立法下工作的人员所受的影响。方法 采用横断面调查设计收集数据,目标是全国的卫生专业人员,主要是医生和护士。该调查有封闭式和开放式回答选项,参考了以前的出版物,并在进一步推广之前进行了试点。通过专业网络和社交媒体进行招募。对定量数据进行描述性分析,对定性数据使用NVivo进行编码并进行主题分析。结果 最终样本量为223。确定的对临床医生的影响包括薪酬不足、需要持续支持以及认识到强制培训的障碍。结论 对卫生从业人员的影响若不加以解决,将对劳动力可持续性产生未来影响。越来越多经过培训的VAD从业人员可能有助于分担临床工作量并防止职业倦怠。VAD从业人员没有得到适当的薪酬,可通过为VAD引入专门的医疗保险福利计划项目来解决。还应关注激励培训,包括持续专业发展认证和适当的资金。支持员工的策略可包括汇报情况、指导、同伴支持和心理咨询。

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