PDF(Pubmed)
Abstract：
Introduction Shared decision-making (SDM) in palliative care is a highly complex process that requires an interdisciplinary team. Interprofessional team members need education on how to facilitate discussion of patient/family wishes at the end of life in hospital settings. So far, interprofessional shared decision-making (IP-SDM) education frameworks have been used to a limited extent in the area of education on palliative care. The aim of this study was to explore policymakers\', health professionals\', faculty members\', and students\' perspectives on implementing an IP-SDM educational framework in palliative care to identify aspects that should be prioritized to further develop interprofessional education for SDM in palliative care. Methods We used the qualitative method to capture the micro, meso, and macro factors using Oandasan and Reeves\' model for the implementation of IP-SDM education regarding palliative care. Data collection tools included in-depth, face-to-face interviews with individual policymakers and focus group interviews with health professionals, faculty members, and undergraduate health professionals. The interview guide explores the teaching of SDM in palliative care, factors that could facilitate or hinder the implementation of IP-SDM education for health professions students in palliative care, and interventions to facilitate the implementation of this approach. This study was conducted at the Oncology and Palliative Care Department at King Abdulaziz Medical City in the Ministry of National Guard Health Affairs and at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. Results The results indicated a high demand for IP-SDM in palliative care. The findings revealed factors that can facilitate or hinder the implementation of IP-SDM education in palliative care for undergraduate health professions students that is going to the local community. Factors include culture, religion, gender, power issues, team hierarchy, and respect among team members. Also, our findings have revealed potential solutions to the hindering factors. Conclusions IP-SDM education in palliative care is a highly relevant topic for improving patient outcomes. However, it might be a complex process to implement, especially given the challenges of palliative care settings. We recommend starting such a course in the early clinical phases of undergraduate health professional education.
摘要：
介绍姑息治疗中的共享决策（SDM）是一个非常复杂的过程，需要跨学科团队。跨专业团队成员需要接受有关如何在医院环境中生命终结时促进患者/家庭愿望讨论的教育。到目前为止,跨专业共享决策（IP-SDM）教育框架在姑息治疗教育领域的使用范围有限。这项研究的目的是探索决策者，卫生专业人员，教职员工\'，和学生关于在姑息治疗中实施IP-SDM教育框架的观点，以确定应优先考虑的方面，以进一步发展姑息治疗中SDM的跨专业教育。方法我们采用定性方法捕获微观，meso,以及使用Oandasan和Reeves模型实施关于姑息治疗的IP-SDM教育的宏观因素。包括深入的数据收集工具，与个别政策制定者的面对面访谈和与卫生专业人员的焦点小组访谈，教员,和本科卫生专业人员。访谈指南探讨了SDM在姑息治疗中的教学，可能促进或阻碍对姑息治疗中的卫生专业学生实施IP-SDM教育的因素，和干预措施，以促进这一方法的实施。这项研究是在国民警卫队卫生事务部阿卜杜勒阿齐兹国王医疗城的肿瘤和姑息治疗部门以及吉达的沙特·本·阿卜杜勒阿齐兹国王健康科学大学进行的，沙特阿拉伯。结果结果表明，姑息治疗对IP-SDM的需求很高。研究结果表明，可能会促进或阻碍针对前往当地社区的本科健康专业学生的姑息治疗中IP-SDM教育的实施。因素包括文化，宗教,性别,权力问题,团队层次结构，团队成员之间的尊重。此外，我们的发现揭示了阻碍因素的潜在解决方案。结论姑息治疗中的IP-SDM教育是改善患者预后的一个高度相关的话题。然而,这可能是一个复杂的过程，特别是考虑到姑息治疗环境的挑战。我们建议在本科健康专业教育的早期临床阶段开始这样的课程。
