Improving Physician Skill at Providing End-of-Life Care

描述(由申请人提供)：本提案的长期目标 是提高医生提供的临终关怀的质量。 具体目标是：1)建立 由团队开发和试行测试的问卷以评估医生 在特定的临终关怀技能方面的表现；2)评估 由通常护理临终病人的医生提供的临终关怀， 包括肿瘤学家、肺病学家、心脏病学家和疗养院 医生；3)探索实施干预措施的机制 改善临终病人的内科护理。 这是一项针对西北地区120名医生的前瞻性队列研究。 美国东南部。医生将每人识别15名患者 (总计=1800人)患有限制生命的疾病。我们将招收病人和一个 每个病人的家属，以及每名医生15名护士 (总数=1,800)谁熟悉这位内科医生？S技艺。所有参与者 会填写问卷评估医生吗？S临终前的技能 关心。调查问卷数据将针对测量结构进行评估， 信度和效度；受访者在问卷数据中的差异将 也要接受检查。我们将根据以下情况向医生提供反馈 调查问卷数据。 这项研究将确定临终关怀的具体优势和劣势 由个别医生和专科医生提供 正在研究中。它还将提供关于当前和潜在的探索性数据 护理在改善临终关怀中的作用。经过验证的调查问卷将 在教育、临床和研究环境中评估和 提高医生临终关怀的质量。结果将允许 调查人员和其他人制定有针对性的教育和系统 干预措施，以提高这种护理的质量。

DESCRIPTION (Provided by Applicant): The long-term objective of this proposal is to improve the quality of end-of-life care provided by physicians. Specific aims are: 1) to establish the measurement characteristics of the questionnaire developed and pilot-tested by the team to assess physician performance at specific end-of-life care skills; 2) to assess the quality of end-of-life care provided by physicians who commonly care for dying patients, including oncologists, pulmonologists, cardiologists and nursing home physicians; 3) to explore mechanisms for implementing interventions for improving physician care for patients at end-of-life. This is a prospective cohort study of 120 physicians in the Northwest and Southeast United States. Physicians will each identify 15 patients (total=1,800) with life-limiting illness. We will enroll patients and a family member for each patient, as well as 15 nurses per physician (total=1,800) who are familiar with the physician?s skills. All participants will complete questionnaires assessing the physician?s skill at end-of-life care. The questionnaire data will be evaluated for measurement structure, reliability, and validity; respondent differences in questionnaire data will also be examined. We will provide feedback to physicians based on the questionnaire data. The study will identify specific strengths and weaknesses in end-of-life care provided by individual physicians and by physicians within the specialties under study. It will also provide exploratory data on present and potential nursing roles in improving end-of-life care. The validated questionnaire will be useful in educational, clinical, and research settings to assess and improve the quality of end-of-life care by physicians. The results will allow investigators and others to develop targeted educational and systemic interventions to improve the quality of this care.