"This is just too awful; I just can't believe I experienced that...": Medical students' reactions to their "most memorable" patient death
"This is just too awful; I just can't believe I experienced that...": Medical students' reactions to their "most memorable" patient death
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DOI：
10.1097/00001888-200507000-00005
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发表时间：
2005-07-01
影响因子：
7.4
通讯作者：
Arnold, RM
中科院分区：
文献类型：
--
作者：
Rhodes-Kropf, J;Carmody, SS;Arnold, RM
目的探讨医学生对“最难忘”的病人死亡的情绪反应及所得到的支持。在美国东北部的两所医学院随机选择了65名三年级医学生参加60-90分钟的开放式和结构化问题的访谈和书面问卷（使用十分制）关于他们“最难忘”的病人死亡。独立审查员对每次访谈进行编码，以确定分析类别。描述性数据来自书面问卷。结果共32个访谈被用于分析。12名（38%）学生与患者接触不到24小时，23名（73%）学生与患者完全不接触或最低限度地接近（10分制0-3分）。28名学生中有16名（57%）认为死亡的影响在情感上非常强大（10分制为7-10分）。死亡的结局，特别是突然死亡，引起了强烈的情绪。16名学生中有4名（25%）认为死亡在情感上非常强大，认为主管的支持量非常不足（10分制为0-3分）。在27例患者由学生团队护理的病例中，有17例（63%）没有讨论死亡。学生认为，从监督医生，死亡和情绪是消极的方面medicine.Conclusions医学生经历了病人的死亡，情绪强大，即使他们不接近病人。与学生的汇报会很少见，许多学生感到支持不足。因此，一个独特的机会，教导有关死亡，情绪和应对压力往往失去了。
Purpose To examine medical students' emotional reactions to their "most memorable" patient death and the support they receive.Method In 2000-01, 65 third-year medical students at two Northeastern U.S. medical schools were randomly selected to participate in 60-90-minute interviews of open-ended and structured questions and a written questionnaire (using a ten-point scale) about their "most memorable" patient death. independent reviewers coded each interview to identify the analytical categories. Descriptive data were generated from the written questionnaire.Results A total of 32 interviews were used in the analysis. Twelve (38%) students were in contact with the patient for less than 24 hours and 23 (73%) were not at all or minimally close to the patient (0-3 on ten-point scale). Sixteen of 28 students (57%) rated the impact of the death as highly emotionally powerful (7-10 on ten-point scale). The finality of deaths, particularly sudden deaths, evoked strong emotions. Four of 16 (25%) students who found the death highly emotionally powerful rated the amount of support from supervisors as extremely inadequate (0-3 on ten-point scale). There was no discussion of the death in 17 (63%) of the 27 cases in which the patient was cared for by the student's team. Students perceived from supervising physicians that death and emotions are negative aspects of medicine.Conclusions Medical students experienced patient deaths as emotionally powerful even when they were not close to the patients. Debriefing sessions with students were rare, and many students felt inadequately supported. Thus, a unique opportunity to teach about death, emotions and coping with stress is often lost.