Chinese Medical Sciences Journal ›› 2018, Vol. 33 ›› Issue (4): 221-227.doi: 10.24920/003509
• Original Article • Previous Articles Next Articles
Xiang Yirong, Ning Xiaohong
Received:
2018-09-16
Accepted:
2018-11-05
Published:
2018-12-30
Online:
2019-01-10
The survey in this study found 66.8% Chinese clinicians feel powerless while facing end-stage patients. Education on palliative medicine in clinicians were associated with less negative feelings, but more careful designations are needed. |
Xiang Yirong,Ning Xiaohong. Recognition of Palliative Care in Chinese Clinicians: How They Feel and What They Know[J].Chinese Medical Sciences Journal, 2018, 33(4): 221-227.
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Basic information | Q1 | Your age |
---|---|---|
Q2 | Your specialty | |
Q3 | Do you have membership of a palliative care association | |
Q4 | What is the type of hospital you are working in | |
Q5 | Where does the hospital you are working locate (Beijing, others) | |
Q6 | How long is your clinical experience as a doctor (<15 years, ≥15 years) | |
Q7 | Your religion | |
Prior training history | Q8 | How many times have you ever attended palliative care training (<2 times, or ≥2 times) |
Q9 | Have you ever attended education course on death? (true or false) | |
Personal experiences | Q10 | Self-experience in family member’s death (true or false) |
Q11 | Talking about death at physician’s own home (never, tried to avoid, discussed reluctantly, or discussed openly) | |
Q12 | Number of patient’s death each month? | |
Self-assessment of familiarity | Q13 | Are you familiar with palliative care? |
Q14 | Are you familiar with the Living Will? | |
Emotional attitude | Q15 | How do you feel when facing end-stage patients (multiple choices) |
Reflection on their clinical practice | Q16 | Patients’ own opinion was considered when discussing treatment with patients’ family. |
Q17 | Agree that doctor should concern about patients’ family members? | |
Q18 | Which is better way to treat end-stage patients? (traditional care, or palliative care) |
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Characteristics | n | (%) | Feel powerless (n) | Χ2 | P | |
---|---|---|---|---|---|---|
Yes | No | |||||
Specialty | ||||||
Medical oncology | 272 | 71.8 | 176 | 96 | 1.822 | 0.185 |
Others | 107 | 28.2 | 77 | 30 | ||
Member of a palliative care association | ||||||
Yes | 110 | 29.0 | 61 | 49 | 8.917 | 0.003 |
No | 269 | 71.0 | 192 | 77 | ||
Hospital level | ||||||
Tertiary hospital | 321 | 84.7 | 211 | 110 | 0.988 | 0.365 |
Non-teriary hospital | 58 | 15.3 | 42 | 16 | ||
Location of hospital | ||||||
Beijing | 76 | 20.1 | 49 | 27 | 0.223 | 0.683 |
Non-capital cities | 303 | 80.0 | 204 | 99 | ||
Working experience | ||||||
≤15 years | 201 | 53.0 | 145 | 56 | 5.591 | 0.022 |
>15 years | 178 | 47.0 | 108 | 70 | ||
Religion | ||||||
Non-religious | 325 | 85.0 | 214 | 111 | 0.848 | 0.436 |
Religious | 54 | 15.0 | 39 | 15 | ||
Previous attended palliative care course | ||||||
≥2 times | 253 | 66.8 | 155 | 98 | 10.334 | 0.001 |
<2 times | 126 | 33.2 | 98 | 28 | ||
Whether attended courses on the death | ||||||
Yes | 83 | 21.9 | 38 | 45 | 21.061 | <0.001 |
No | 296 | 78.1 | 215 | 81 | ||
Whether experienced family member’s death | ||||||
Yes | 300 | 79.2 | 192 | 108 | 4.921 | 0.031 |
No | 79 | 20.8 | 61 | 18 | ||
Atmosphere talking about death at home | ||||||
Openly | 128 | 33.8 | 78 | 50 | 2.947 | 0.106 |
Seldom | 251 | 66.2 | 175 | 76 | ||
Number of patient death | ||||||
>2 cases/ month | 144 | 38.0 | 92 | 52 | 0.859 | 0.370 |
≤2 cases/ month | 235 | 62.0 | 161 | 74 | ||
sum | 379 | 100 | 253 | 126 |
"
Characteristics of doctors | Palliative care | Living will | |||
---|---|---|---|---|---|
OR | P value | OR | P value | ||
Age | 0.999 | 0.949 | 0.975 | 0.340 | |
Specialty | 1.042 | 0.920 | 0.823 | 0.687 | |
Religion | 1.270 | 0.599 | 1.225 | 0.700 | |
Member of palliative care associations | 3.228 | <0.001 | 3.062 | 0.007 | |
Hospital level | 2.710 | 0.066 | 2.171 | 0.264 | |
location of working hospital | 1.529 | 0.254 | 1.825 | 0.159 | |
Years of working experience | 1.292 | 0.476 | 1.022 | 0.969 | |
Attending courses on palliative care | 6.923 | 0.002 | 1.781 | 0.409 | |
Attending courses on the death | 5.582 | <0.001 | 7.340 | <0.001 | |
Experienced family member’s death | 0.829 | 0.649 | 1.202 | 0.746 | |
Atmosphere when talking about death at home | 1.468 | 0.237 | 1.657 | 0.194 | |
Number of patient death each month | 1.332 | 0.372 | 1.039 | 0.923 |
"
Questions and responses | Familiar with palliative care | χ2 | P value | |
---|---|---|---|---|
Yes (n=90) n(%) | No (n=289) n(%) | |||
Q15: How do you feel when facing end-stage patients? | ||||
Powerless | 46(51.1) | 207(71.6) | 13.015 | <0.001 |
Others | 44(48.9) | 82(28.4) | ||
Q16: Do you considert patients’ own willing for treatment? | ||||
1 | 2(2.2) | 18(6.2) | 28.754 | <0.001 |
2 | 8(8.9) | 78(27.0) | ||
3 | 33(36.7) | 121(41.9) | ||
4 | 47(52.2) | 72(24.9) | ||
Q17: Do you agree that doctors should concern about patients’ family members? | ||||
1 | 0(0) | 4(1.4) | 24.406 | <0.001 |
2 | 1(1.1) | 7(2.4) | ||
3 | 6(6.7) | 60(20.8) | ||
4 | 12(13.3) | 74(25.6) | ||
5 | 71(78.9) | 144(49.8) | ||
Q18: Which do you think is better way to treat end-stage patients? | ||||
Palliative care | 86(95.6) | 236(81.6) | 10.764 | 0.005 |
Traditional care | 4(4.4) | 53(18.4) |
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