医学生对照顾临终者及其家人的信心：系统评价

丽贝 卡·, 伊莱 尼·, 朱丽 叶·, 嘉莉 ·优, 杰弗 里·
英国医学教育系

摘要

综合医学委员会希望医学毕业生能够以技巧、临床判断和同情心来照顾垂死的病人。英国的调查不断显示，
初级医生在为临终者提供护理时信心不足，并且越来越痛苦。本系统评价访问了MEDLINE、CINAHL、EMBASE、
ISI Web of Science、ERIC、PsycINFO、British Education Index 和 Cochrane Review数据库，旨在确定全球文献中关于
医学本科生对照顾垂死患者的信心的证据。该数据提取包括基线信心的测量、相关的评估工具、应用教育干预的细
节、通过进行了干预前/干预后的置信度比较以及探讨了影响置信水平的因素。符合条件的研究包括“医学生”、“信
心”和“垂死”等相关术语。此评价纳入了15项符合条件的研究，展示了评估工具的多样性。多数研究表明干预前，
学生在为临终患者提供症状管理、家庭支持和心理-精神支持方面信心不足；而八项干预研究表明干预后信心增加。
本科生缺乏对垂死患者的接触和本科姑息治疗课程缺乏结构被认为是导致信心低下的因素。这篇综述阐明了医学本
科生对临终关怀的信心的客观记录。确定未能让毕业生为临床实践的现实做好准备的教学将有助于为未来的本科姑
息治疗课程规划提供信息。

关键词

信心；医学生；临终关怀

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