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How Primary Care Clinicians Process Patient Death: Logistics, Emotions, and Opportunities for Structural Support.初级保健临床医生如何处理患者死亡:后勤、情感以及结构支持的机会。
J Gen Intern Med. 2024 Sep;39(12):2277-2283. doi: 10.1007/s11606-024-08702-0. Epub 2024 Mar 8.
2
Synthesising existing research on complicated grief in intellectual disability: findings from a systematic review.对智力残疾人群中复杂悲伤的现有研究进行综合:系统评价的结果。
J Intellect Disabil Res. 2022 Nov;66(11):833-852. doi: 10.1111/jir.12973. Epub 2022 Aug 30.
3
Supporting bereavement and complicated grief in primary care: a realist review.初级保健中对丧亲之痛和复杂性哀伤的支持:一项现实主义综述
BJGP Open. 2021 Jun 30;5(3). doi: 10.3399/BJGPO.2021.0008. Print 2021 Jun.
4
Primary medical care continuity and patient mortality: a systematic review.初级医疗保健的连续性与患者死亡率:一项系统评价。
Br J Gen Pract. 2020 Aug 27;70(698):e600-e611. doi: 10.3399/bjgp20X712289. Print 2020 Sep.
5
I Attended My Patient's Funeral, and That Is Family Medicine.
Fam Med. 2019 Nov;51(10):870. doi: 10.22454/FamMed.2019.811955.
6
Early treatment with talk therapy or antidepressants in severely bereaved people and risk of suicidal behavior and psychiatric illness: an instrumental variable analysis.对严重丧亲者进行谈话治疗或抗抑郁药的早期治疗与自杀行为及精神疾病风险:一项工具变量分析
Clin Epidemiol. 2018 Aug 24;10:1013-1026. doi: 10.2147/CLEP.S157996. eCollection 2018.
7
Do Primary Care Physicians Help the Bereaved With Their Suicide Losses: Loss Survivor Perceptions of Helpfulness From Physicians.初级保健医生是否能帮助丧亲者应对自杀损失:丧亲者对医生帮助的看法。
Omega (Westport). 2020 Feb;80(3):476-489. doi: 10.1177/0030222817742822. Epub 2017 Nov 16.
8
Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis.成人丧亲之痛中持续性悲伤障碍的患病率:一项系统评价与荟萃分析。
J Affect Disord. 2017 Apr 1;212:138-149. doi: 10.1016/j.jad.2017.01.030. Epub 2017 Jan 23.
9
Hospital-based bereavement services following the death of a child: a mixed study review.儿童死亡后基于医院的哀伤辅导服务:一项混合研究综述
Palliat Med. 2015 Mar;29(3):193-210. doi: 10.1177/0269216314556851. Epub 2014 Nov 13.
10
Nature and impact of grief over patient loss on oncologists' personal and professional lives.肿瘤科医生因患者离世而产生的悲痛对其个人生活和职业生涯的性质及影响。
Arch Intern Med. 2012 Jun 25;172(12):964-6. doi: 10.1001/archinternmed.2012.1426.

综合与家庭医学中悲伤家庭的随访:一项关于家庭医生实践与态度的横断面研究

Follow-up of grieving families in general and family medicine: a cross-sectional study on the practices and attitudes of family doctors.

作者信息

Leite Costa Fábio, Barbosa Miguel

机构信息

University of Beira Interior Faculty of Health Sciences, Covilhã, Castelo Branco District, Portugal

CICPSI, Faculty of Psychology, University of Lisbon, Lisbon, Lisbon, Portugal.

出版信息

Fam Med Community Health. 2025 Aug 24;13(3):e003296. doi: 10.1136/fmch-2025-003296.

DOI:10.1136/fmch-2025-003296
PMID:40854614
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12410656/
Abstract

INTRODUCTION

Family physicians (FPs) provide essential support during life's most challenging moments, including experiences of grief and loss. After a patient's death, FPs are expected to provide information and emotional support to bereaved family members. Prior research suggests that bereaved relatives expect follow-up contact from their FP, acknowledging it as part of the physician's role. This study aims to explore the practices and attitudes of FPs towards bereaved family members.

METHODS

A cross-sectional, descriptive study was conducted through an online questionnaire, exploring participants' perceived role in bereavement care, the type of support offered to families, available resources in primary care, as well as personal knowledge and approach on grief. This questionnaire was distributed via digital platforms to general and family medicine doctors.

RESULTS

A total of 210 physicians participated (84.3% female; 53.8% in residency), with a median age of 32 years old. On average, each FP experienced five patient deaths, most often reported by family members. More than half (53.3%) contacted bereaved families in fewer than 25% of cases, typically within 7 days of the death, most commonly by phone (76.5%).

CONCLUSION

This study highlights significant gaps in the bereavement follow-up practices of FPs in Portugal. Findings emphasise the need for integrated bereavement care guidelines in primary care, institutional policies and investment in targeted training programmes to enhance grief's approach. The reported lack of grief training reinforces the need to integrate grief education into medical curriculum and continuous professional development. Structural improvements, such as the implementation of automatic death notifications within the healthcare system, are also critical for enabling timely and effective support.

摘要

引言

家庭医生在人生最具挑战的时刻提供至关重要的支持,包括悲伤和失落的经历。患者去世后,家庭医生应向失去亲人的家庭成员提供信息和情感支持。先前的研究表明,失去亲人的亲属期望家庭医生进行后续联系,并将其视为医生职责的一部分。本研究旨在探讨家庭医生对失去亲人的家庭成员的做法和态度。

方法

通过在线问卷进行了一项横断面描述性研究,探讨参与者在丧亲护理中所感知的角色、向家庭提供的支持类型、初级保健中的可用资源以及个人对悲伤的认识和处理方法。该问卷通过数字平台分发给普通和家庭医学医生。

结果

共有210名医生参与(84.3%为女性;53.8%为住院医生),中位年龄为32岁。平均而言,每位家庭医生经历过5例患者死亡,大多由家庭成员报告。超过一半(53.3%)的医生在不到25%的病例中与失去亲人的家庭联系,通常在患者死亡后7天内,最常见的方式是电话联系(76.5%)。

结论

本研究凸显了葡萄牙家庭医生在丧亲后续护理做法上的重大差距。研究结果强调,初级保健中需要有综合的丧亲护理指南、机构政策以及对针对性培训项目的投入,以改进对悲伤的处理。报告中提到缺乏悲伤培训,这进一步强化了将悲伤教育纳入医学课程和持续专业发展的必要性。结构上的改进,如在医疗系统内实施自动死亡通知,对于提供及时有效的支持也至关重要。