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评估基层医疗医生的姑息治疗教育需求:一项邮件调查结果

Assessing needs for palliative care education of primary care physicians: results of a mail survey.

作者信息

Haines C S, Thomas Z

机构信息

Louis Schulman Cancer Epidemiology Unit, College of Medicine, University of Saskatchewan, Saskatoon, Canada.

出版信息

J Palliat Care. 1993 Spring;9(1):23-6.

PMID:7684077
Abstract

The purpose of this study was to determine continuing education needs in the area of palliative care, as defined by family practice physicians. The methodology consisted of an anonymous questionnaire mailed in October, 1991, to all family practitioners in the city of Regina, Saskatchewan having admission privileges at any of the city's three hospitals. Replies were received from 31.1% of that population; the worst-case estimate is that about half of the city's palliative care caseload in 1991 was under the care of these respondents. In a priority-ranking format, physicians rated pain assessment and management as the patients' greatest need and their greatest continuing education need. Although emotional support and communication were highly ranked among other needs of patients, they were not highly ranked among education needs. Grand rounds was indicated as the educational venue of preference. Longer, more intensive educational formats were not selected. Communication of palliative status, including "Do not resuscitate" status, has reportedly become a routine practice. We have concluded that palliative care education should focus on the felt needs of family practice physicians for technical competence in pain assessment and management, using abbreviated formats. Cautious introduction of content areas and educational methods more likely to address patient needs is warranted. A one- or two-day workshop devoted to bereavement guidance might be a concrete focus for communication-oriented continuing education.

摘要

本研究的目的是确定家庭医生所定义的姑息治疗领域的继续教育需求。研究方法包括于1991年10月向萨斯喀彻温省里贾纳市所有在该市三家医院享有收治特权的家庭医生邮寄一份匿名问卷。收到了该群体中31.1%的回复;最坏情况估计是,1991年该市约一半的姑息治疗病例由这些受访者负责护理。医生们以优先排序的形式将疼痛评估和管理列为患者最大的需求以及他们最大的继续教育需求。尽管情感支持和沟通在患者的其他需求中排名很高,但在教育需求中排名并不高。大查房被指明是首选的教育场所。未选择更长、更密集的教育形式。据报道,包括“不要复苏”状态在内的姑息治疗状况的沟通已成为常规做法。我们得出结论,姑息治疗教育应聚焦于家庭医生在疼痛评估和管理方面对技术能力的实际需求,采用简短的形式。谨慎引入更有可能满足患者需求的内容领域和教育方法是有必要的。为期一天或两天的哀伤辅导工作坊可能是面向沟通的继续教育的一个具体重点。

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