缓和医疗会诊在综合医院实施中医生的感受和看法

曲璇; 江南; 葛楠; 宁晓红

doi:10.24920/003515

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缓和医疗会诊在综合医院实施中医生的感受和看法

Chinese Medical Sciences Journal 2018年33卷第4期页码：228-233

论著 | Updated：2024-04-10

- 缓和医疗会诊在综合医院实施中医生的感受和看法
- Affiliations：
  
  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
- Author bio：
- Funds：
  
  北京协和医学院教改立项课题;Supported by the Educational Reform Project of Peking Union Medical College(2015zlgc0120)
- DOI：10.24920/003515
  中图分类号：
- 收稿日期：2018-09-18，
  
  录用日期：2018-10-22，
  
  网络出版日期：2018-01-07，
  
  纸质出版日期：2018-01-07
- Accepted：
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曲璇, 江南, 葛楠, 等. 缓和医疗会诊在综合医院实施中医生的感受和看法[J]. Chinese Medical Sciences Journal, 2018,33(4):228-233.

Qu Xuan, Jiang Nan, Ge Nan, et al. Physicians’ Perception of Palliative Care Consultation Service in a Major General Hospital in China[J]. Chinese medical sciences journal, 2018, 33(4): 228-233.
曲璇, 江南, 葛楠, 等. 缓和医疗会诊在综合医院实施中医生的感受和看法[J]. Chinese Medical Sciences Journal, 2018,33(4):228-233. DOI： 10.24920/003515.

Qu Xuan, Jiang Nan, Ge Nan, et al. Physicians’ Perception of Palliative Care Consultation Service in a Major General Hospital in China[J]. Chinese medical sciences journal, 2018, 33(4): 228-233. DOI： 10.24920/003515.

摘要

目的

院内缓和医疗会诊在中国一些医学中心正在开始实施。本研究旨在评估综合医院内实施缓和医疗会诊过程中申请会诊的医疗服务团队医生和缓和医疗会诊团队成员的感受和看法

探讨综合医院院内缓和医疗会诊服务模式的有效性。

方法

北京协和医院缓和医疗团队在2016年1月~2016年12月在院内对疾病晚期患者开展会诊37例次。通过自制调查问卷评估医生对缓和医疗会诊给患者、患者家属和医务人员自身所带来的帮助的看法。邀请正式申请缓和医疗会诊的各专科医师、非正式申请会诊的老年科的住院医师以及进修医师

以及缓和医疗团队成员通过社交媒体扫描二维码参与问卷调查。

结果

共收到103份问卷

其中有20人为缓和医疗团队成员

37人为申请缓和医疗会诊的医师

其余

人为老年医学科轮转的住院医师及进修医师。非缓和医疗团队的被调查者中94.0%认为缓和会诊帮助减轻了患者的痛苦症状

89.2%认为对患者的生活质量有改善。分别有91.6%、95.2%和90.4%的医生认为缓和医疗会诊降低了患者、家属和医务人员的焦虑情绪

有96.4%认为有助于改善医患关系

97.6%认为降低了医疗风险

96.4%表示对会诊过程和达到会诊目的总体满意。对于“加深了主管医师对缓和医疗的认识”

非缓和医疗团队成员的认同率高于缓和医疗团队（97.6%

vs.

80%

0.05）

而两组医生都表示愿意学习更多缓和医学知识( 100%

vs.

96.4%

0.05)。

结论

提供终末期照护的临床医生对院内缓和医疗团队的会诊服务有较高的认可度和接受度

认为从病人、家属以及医生自身方面均受益。在综合医院内对终末期患者开展缓和医疗会诊是在中国推广缓和医疗较好的模式。

Abstract

Objective

s The in-hosptial palliative care consultation (PCC) is emerging as a routine service in some medical center in China. The current study evaluated how physicians in primary care team and consultation team perceive the PCC service for the purpose of investigating the effectiveness of this consultation model in a general hospital.

Methods

In-hosptial palliative care consultations have been carried out at Peking Union Medical College Hosptial by a dedicated consultation team

and 37 consultations were completed in 2016. A questionnaire was designed for physicians in terms of its benefits to patients

their family as well as the primary care team. Physicians who applied for consultation in 2016 formally (requested from the department other than the Geriatrics) and informally (by rotating residents and unemployed visiting doctors in geriatric department) were invited to participate in the survey by scanning a two dimentional code on social networking platform.

Results

There were 103 physicians participated in the survey

including primary care physicians from the department of Internal Medicine (

=8)

Gynaecology (

=16) and Surgery (

=13)

rotating residents (

=30)

visiting doctors (

=16) in Geriatric department

and PCC team members (

=20). 94.0% of the non-PCC physicians agreed that PCC relieved the suffering of patients; 89.2% thought PCC improved the quality of patients’ life; there were 91.6%

95.2%

90.4% physicians who felt it relieved the anxiety of patients

of family members and of care providers

respectively. There were 96.4% physicians who felt it could ease the tension in physician-patient relationship; 97.6% felt it lower the risk for medical negligence

and 96.4% of doctors who applied for PPC felt satisfied with PCC service in terms of process and achieving objectives of consultation. More primary-team physician agree “PCC service helps the physicians better understand palliative care” than PCC members (97.6%

vs.

80%

0.05)

while both were interested in learning more on palliative medicine (100%

vs.

96.4%

0.05).

Conclusion

Palliative care consultation service in a general hospital is efficacious and acclaimed.The primary care physicians and the PCC members hold positive attitudes to the benefits that the PCC services bring to patients

family members

and physicians themselves. PCC for terminal patients in a general hospital may serve as a good modle for promotion of palliative care in China.

关键词

Keywords

references

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