医学生对缓和医疗及其在终末期肾病治疗中的认知度调查

A survey from medical students on the cognition and application of palliative care in end-stage kidney disease

目的通过调查临床医学专业学生对缓和医疗及其在终末期肾脏病(end-stage renal disease,ESRD)治疗中应用的认知度,对国内缓和医疗教育现状进行补充。方法2018年12月,随机抽取上海交通大学医学院2014级和2015级临床医学专业200名学生,采用问卷星调查医学生对缓和医疗及其在终末期肾脏病治疗中应用的认知度、医学生在本科教育期间缓和医疗教育现状。结果临床医学专业学生对缓和医疗关注度较欠缺,59.6%(102/171)的学生未能正确认识缓和医疗和姑息治疗的区别;42.1%(72/171)的学生对ESRD患者的缓和医疗需求认知不足;对于家属的缓和医疗需求,有实习经验的学生理解深度明显高于没有实习经验的学生[(4.53±0.55)分比(4.34±0.69)分,t=2.08]。81.3%(139/171)的学生未接触过缓和医疗知识,其中83.5%(116/139)的学生更希望从临床实践中获取缓和医疗知识。结论临床医学专业学生对缓和医疗及其在ESRD中应用的认知度仍需提高,有关部门应丰富学生获取缓和医疗知识的途径,同时结合临床实际,重视开展针对肾脏疾病的缓和医疗教育。

Objective To investigate the cognition and application of palliative care in ESRD among clinical medicine students and to provide some reference for the reform of medical education in medical curriculums.Methods From December in 2018, self-designed questionnaires were sent out to 200 medical undergraduate selected randomly from the grade 2014 and 2015 of Shanghai Jiao Tong University School of Medicine. Questionnaire stars were used to investigate the awareness of medical students on palliative care and its application in the treatment of end-stage renal disease, and the current situation of palliative medical education of medical students during undergraduate education.Results 59.6%(102/171) students failed to understand the difference between palliative care and palliative care;while 42.1%(72/171) of students had insufficient understanding of palliative care for ESRD patients. 81.3%(139/171) of students had never learned palliative care program in class and 83.5%(116/139) of them prefer to get knowledge of palliative care from clinical practice rather than in class. We also found students experienced clinical practice had deeper understanding on palliative care than those without clinical practice[(4.53±0.55)vs(4.34±0.69), t=2.08].Conclusions Cognition and application of palliative care in ESRD among medical students still needs to be improved. Effective access is urged to obtain the knowledge of palliative care for medical students.