菲律宾一所国立大学医院的医生对晚期癌症患者预先护理计划的认识、态度和做法

S. Estreller, J. Pilapil, F. I. Ting, I. Real, E. Dee
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引用次数: 0

摘要

目的:预先护理计划(ACP)通常是患者权利和决策过程的一部分。它是病人-医生护理动态关系的一个组成部分,尤其是在危及生命的疾病中。在菲律宾这个拥有 1.1 亿人口的国家,人们对 ACP 和预先医疗指示的使用知之甚少。本研究旨在探讨菲律宾一所国立大学医院的住院医师对晚期癌症患者 ACP 的知识、态度和实践 (KAP)。研究方法采用横断面设计,对住院医师进行在线调查,发放自制问卷,共有 202 名受访者回答了问卷。结果结果显示,住院医师普遍认为:(1)姑息医学和临终关怀医学是一样的,没有区别;(2)乐于与患者及其家属讨论姑息治疗方案和病情预后,但(3)不会定期向他们发起或提供姑息治疗方案;(4)认为缺乏时间、害怕给患者及其家属带来情绪困扰以及个人不适是开展姑息治疗方案的障碍;(5)没有接受过正规的姑息治疗方案培训,但如果有机会,愿意接受此类培训。结论本研究强调了在医生中持续弥合和团结与 ACP 相关的 KAP 的必要性。应开展进一步研究,以制定适当的培训计划,并更好地探索菲律宾晚期癌症患者所经历的临终关怀的复杂性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Physicians’ knowledge, attitudes and practices on advance care planning for patients with advanced cancer in a National University Hospital in the Philippines
Purpose: Advance care planning (ACP) is generally part of patients’ rights and decision-making processes. It is a component of the patient–physician care dynamics, especially in the context of life-threatening illness. Little is known about ACP and the utilisation of advance directives in the Philippines, a country of 110 million people. The study aimed to explore the knowledge, attitudes and practices (KAPs) of resident physicians in a national university hospital in the Philippines regarding ACP for patients with advanced cancer. Methods: Using a cross-sectional design involving resident physicians, an online survey with a self-administered questionnaire was distributed and answered by a total of 202 respondents. Results: Results show that resident physicians generally: (1) view palliative and hospice medicine to be the same and without differences, (2) are comfortable with discussing ACP and prognosis of medical conditions with patients and their families, but (3) do not regularly initiate or offer ACP to them, (4) identify a lack of time, fear of imparting emotional distress to patients and their families and personal discomfort as barriers to conducting ACP and (5) have had no formal training for ACP but are willing to undergo such formation, given the opportunity. Conclusion: This study highlights the continuing need to bridge and unite KAPs pertaining to ACP among physicians. Further studies should be undertaken to device a proper training program and better explore the complexities of end-of-life care as it is experienced by Filipino patients with advanced cancer.
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