Improving Physician Skill at Providing End-of-Life Care

描述（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）建立测量特性的 由团队开发并试点测试的问卷， 具体的临终关怀技能的表现; 2）评估质量 由通常照顾垂死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 （3）探索实施干预措施的机制， 改善医生对临终病人的护理。 这是一项对西北地区120名医生进行的前瞻性队列研究， 美国东南部。医生们将分别确定15名患者 （总数= 1，800人）患有限制生命的疾病。我们将招募患者， 每名病人有一名家庭成员，每名医生有15名护士 （共1,800人）谁熟悉医生？的技能。所有参与者 将完成评估医生的问卷调查？在生命末期的技能 在乎将对问卷数据进行评估，以确定测量结构， 可靠性和有效性;问卷数据的受访者差异将 也要检查。我们将根据以下信息向医生提供反馈： 问卷调查数据。 这项研究将确定临终关怀的具体优势和弱点 由个体医生和专科医生提供 正在研究中。它还将提供有关目前和潜在的探索性数据 护理在改善临终关怀中的作用。经验证的问卷将 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的 采取干预措施，提高护理质量。

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.