Barriers to providing palliative care and priorities for future actions to advance palliative care in Japan: A nationwide expert opinion survey
Barriers to providing palliative care and priorities for future actions to advance palliative care in Japan: A nationwide expert opinion survey
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DOI：
10.1089/jpm.2006.0154
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发表时间：
2007-04-01
影响因子：
2.8
通讯作者：
Uchitomi, Yosuke
中科院分区：
文献类型：
--
作者：
Miyashita, Mitsunori;Sanjo, Makiko;Uchitomi, Yosuke
目的：姑息治疗专家面临着广泛的障碍，提供有效的姑息治疗。我们进行了一项调查，以确定现有的障碍，从日本的姑息治疗专家的角度来看，并确定未来的行动，以克服这些barriers.Methods的优先事项：我们进行了一项横截面邮件调查在2004年12月。我们向日本姑息医学和临终关怀协会的成员发出了2607份问卷。我们向所有受访者提出了两个开放式问题，涉及日本姑息治疗背景下的障碍和未来行动。总共，426份问卷被退回（响应率为16%）。结果：我们确定了95个不同的答案，提供有效的姑息治疗的障碍。最常见的三个答案是“全科医生缺乏兴趣，知识和技能”（n = 203），“一般人群缺乏对姑息治疗的知识和误解”（n = 122），“全科医生未能提供信息和缺乏沟通技巧”（n = 89）。我们确定了136个关于改善姑息治疗所需的未来行动的不同答案。最常见的三个答案是“在医院组织姑息治疗学习会议或病例会议”（n = 122），“向普通人群提供姑息治疗信息”（n = 117）和“在本科教育中，将姑息治疗作为必修课程”（n = 88）。我们确定了提供有效姑息治疗的许多障碍，不仅与医生有关，还与经济因素和一般人群有关。这些研究结果表明，要克服这些障碍，我们需要在许多方面采取行动，包括提高社会意识和实现政治变革，以及解决与从业者有关的问题。我们优先考虑了未来的行动。查明了最常见的紧急问题。我们希望有关组织的合作努力将改善日本的姑息治疗。
Objectives: Palliative care specialists are faced with extensive barriers to providing effective palliative care. We carried out a survey to identify existing barriers from the point of view of palliative care experts in Japan and determine the priorities for future actions to overcome these barriers.Methods: We conducted a cross-sectional mail survey in December 2004. We sent out 2607 questionnaires to members of the Japanese Society of Palliative Medicine and Hospice Palliative Care Japan. We asked all respondents two open-ended questions regarding barriers and future actions in the context of palliative care in Japan. In total, 426 questionnaires were returned (response rate of 16%).Results: We identified 95 different answers concerning barriers to providing effective palliative care. The three most frequent answers were "general medical practitioners' lack of interest, knowledge, and skills" (n = 203), "general population's lack of knowledge and misunderstandings about palliative care" (n = 122), and "general medical practitioners' failure to provide information and lack of communication skills" (n = 89). We identified 136 different answers concerning future actions required to improve palliative care. The three most frequent answers were "organize study sessions on palliative care or case conferences in hospitals" (n = 122), "provide information about palliative care to the general population" (n = 117), and " in undergraduate education, make palliative care a compulsory course" (n = 88).Conclusions: We identified numerous barriers to providing effective palliative care, related to not only medical practitioners, but also economic factors and the general population. These findings suggest that to overcome these barriers, we need to take action on many fronts, including increasing social awareness and effecting political change, as well as addressing problems relating to practitioners. We prioritized the future actions. The most frequent urgent problems were identified. We hope that collaborative efforts by the relevant organizations will improve palliative care in Japan.