Hematology/Oncology Fellows' Training in Palliative Care
Hematology/Oncology Fellows' Training in Palliative Care
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DOI：
10.1002/cncr.25952
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发表时间：
2011-09-15
期刊：
影响因子：
6.2
通讯作者：
Block, Susan D.
中科院分区：
文献类型：
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作者：
Buss, Mary K.;Lessen, David S.;Block, Susan D.
背景：姑息治疗被认为是肿瘤学实践中不可或缺的一部分，但许多肿瘤学家报告说，在关键的姑息治疗领域，如症状管理、心理社会护理和沟通技能方面培训不足。这份报告的作者试图评估肿瘤学奖学金中姑息治疗教育的数量和质量。方法：二年级肿瘤学研究员完成了一项104项的调查，该调查是根据全国医学生和住院医生的调查进行修改和改编的。项目允许比较姑息治疗和非姑息治疗的主题。结果：在402名符合条件的研究员中，63.2%的人回答(n=254)。受访者中有52%是男性，62%是高加索人，是美国医学院毕业生。26%的人完成了姑息治疗轮换。研究员对团契教学的整体质量的评价高于对姑息治疗的教学(1-5分，3.7v3.0；t=10.2；P<；.001)。临终沟通技能被观察(81%)和收到反馈(80%)的比率很高。患者的心理社会需求受到了一些关注：57%的研究员报告说，他们被传达为一种核心能力，但只有32%的研究员在生命末期接受了关于评估和管理抑郁症的明确教育。研究员很少报告接受阿片类药物轮换的明确教育(33%)。在测试基本姑息护理知识的4个项目中，研究员的中位数为2分，只有23%的人正确地进行了阿片类药物转换。结论：研究员评价姑息治疗教育的质量低于整体肿瘤学培训，并可能受益于更多关于疼痛管理、心理社会护理和沟通技能的教学。癌症杂志2011；117：4304-11。(C)2077年美国癌症协会
BACKGROUND: Palliative care is recognized as integral to the practice of oncology, yet many oncologists report inadequate training in critical palliative care domains, such as symptom management, psychosocial care, and communication skills. The authors of this report sought to assess the quantity and quality of palliative care education within oncology fellowships. METHODS: Second-year oncology fellows completed a 104-item survey that was modified and adapted from a national survey of medical students and residents. Items allowed comparison between palliative care and nonpalliative care topics. RESULTS: Of 402 eligible fellows, 63.2% responded (n = 254). Respondents were: 52% men, 62% Caucasian, and 64% US medical school graduates. Twenty-six percent had completed a palliative care rotation. Fellows rated the overall quality of fellowship teaching more highly than teaching on palliative care (3.7 v 3.0 on a 1-5 scale; t=10.2; P < .001). Rates of being observed (81%) and receiving feedback (80%) on an end-of-life communication skill were high. Psychosocial needs of patients received some attention: Fifty-seven percent of fellows reported that they were conveyed as a core competency, but only 32% of fellows received explicit education on assessing and managing depression at the end of life. Fellows rarely reported receiving explicit education on opioid rotation (33%). Fellows scored a median of 2 of 4 items that tested basic palliative care knowledge, and only 23% correctly performed an opioid conversion. CONCLUSIONS: Fellows rated the quality of palliative care education as inferior to overall oncology training and may benefit from more teaching on pain management, psychosocial care, and communication skills. Cancer 2011;117:4304-11. (C) 2077 American Cancer Society