硕士研究生缓和医疗认知水平与实践能力的调查及影响因素  

Investigation of cognition and practical ability in palliative care among master′s degree candidates and its influencing factors

作　　者：曲璇 张丁月 葛楠 郑莹 戴晓艳[4] 宁晓红 QU Xuan;ZHANG Ding-Yue;GE Nan;ZHENG Ying;DAI Xiao-Yan;NING Xiao-Hong(Department of Geriatrics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of Oncology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Department of International Medical Services,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院老年医学科,北京100730 [2]中国医学科学院北京协和医学院,北京100730 [3]中国医学科学院北京协和医学院北京协和医院肿瘤科,北京100730 [4]中国医学科学院北京协和医学院北京协和医院国际医疗部,北京100730

出　　处：《中华老年多器官疾病杂志》2022年第11期831-834,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：北京协和医学院基金(2019zlgc0131)。

摘　　要：目的了解北京某教学医院硕士研究生对缓和医疗的认知水平及实践能力,并分析影响因素。方法应用自设问卷对2019~2021年度参加缓和医疗必修课程的779名硕士研究生进行问卷调查。采用SPSS 22.0统计软件进行数据分析,组间比较采用t检验。结果授课前,学生的缓和医疗认知水平及实践能力各项问题得分为2~3分(满分为5分)。其中,在“能够缓解患者撤除呼吸机后呼吸困难的痛苦”及“能够自然地和家属讨论器官捐献问题”方面得分较低,分别为(1.98±1.35)及(1.88±1.34)分,而在“能够对临终患者及家属表示共情”“与家属自如谈论抢救意愿”“能够在患者临终前选择适合的肠内肠外营养支持”及“高年资同事为学习临终患者照顾树立了榜样”方面得分较高,分别为(3.00±1.38)、(3.05±1.41)、(3.06±1.40)及(3.41±1.55)分。“曾经接受过缓和医疗教育”“作为医师参与过患者死亡过程”以及“有自身罹患重病住院、近亲友离世或床前探望重病或临终亲友经历”的学生,缓和医疗认知水平及实践能力显著提高(P<0.05)。结论授课前,学生的缓和医疗认知水平及实践能力整体偏低,体现了开设缓和医疗课程的必要性和重要性。建议对学生薄弱环节采取针对性教学。Objective To understand the cognition and practical ability in palliative care among master′s degree candidates in a teaching hospital in Beijing and to analyze the influencing factors. Methods A self-designed questionnaire was used to investigate 779 postgraduate students who had taken the compulsory course of palliative medicine from 2019 to 2021. SPSS statistics 22.0 was used for data analysis and t-test for comparison between groups. Results Pre-class students scored 2 to 3 points out of 5 for all the cognitive indexes of palliative care and practice ability. The lower scores were(1.98±1.35) points for “Relieving the pain of dyspnea after withdrawing ventilator” and(1.88±1.34) points for “Discussing freely organ donation with family members”, and the scores were higher for “Expressing empathy to the dying patients and their family members”(3.00±1.38) points, “Discussing freely intention for resuscitation with their family members”(3.05±1.41) points, “Being able to choose appropriate enteral and parenteral nutrition support for the dying patients”(3.06±1.40) points, and “Senior colleagues setting an example for caring for the dying patients”(3.41±1.55) points. Students who "have received education in palliative care", "have gone through the patients′ death as doctors", and "have had experience of hospitalization because of severe illness, or of being bereft of relatives and friends, or of visiting dying relatives and friends" have significantly enhanced cognition about palliative care and practical ability(P<0.05). Conclusion Students have poor cognition and weak practice ability in palliative care, which shows the necessity and importance of the courses in palliative care. Targeted education is recommended in the weakness of knowledge for the students.

关 键 词：认知 实践能力 缓和医疗 医学教育 

分 类 号：R48[医药卫生—临床医学] G642.3[文化科学—高等教育学]