Assessing the Understanding of and Attitude toward Hospice Palliative Care in Taiwan: A Study of Students and Physicians Located on the Same University Hospital Campus in Central Taiwan

台灣中部某醫學大學之醫學生與其附設醫院之醫師對於安寧療護態度與知識之研究

陳秋媚(Chiu-Mei Chen) ； 周希諴(Hsi-Hsien Chou) ； 陳素蘭(Su-Lan Chen) ； 鄭向帆(Hsiang-Fan Cheng) ； 賴思岑(Szu-Tsen Lai) ； 胡文杰(Wen-Chieh Hu) ； 洪維廷(Wei-Ting Hung) ； 王素鴻(Su-Hung Wang) ； 黃智棼(Chih-Feng Huang) ； 王淑如(Shu-Ju Wang) ； 楊友華(Andrew)

《中山醫學雜誌》 14卷2期 (2003/05) Pp. 231-237

摘要

The professional community and society at large in Taiwan are gradually recognizing the benefits that hospice palliative care can deliver in terms of improved quality of terminal care and dignity for terminally ill patients. In order to assess the status of hospice palliative care in the medical curriculum as currently taught in Taiwan, the authors developed a study to determine a respondent’s knowledge of and attitudes toward hospice palliative. This study was then executed on a study population of medical students and practicing physicians located at a university hospital campus in central Taiwan. Medical students in their first through fifth years and physicians practicing at the university hospital were requested to participate. We designed a questionnaire covering three “domains”, which the respondents were requested fill out on their own time.
The first domain tested a respondent’s knowledge of hospice palliative care basics. It included four sections covering 1) the definition of hospice palliative care; 2) the types of diseases typically covered by hospice palliative care; 3) items of hospice palliative care; and 4) the component members of a standard hospice palliative team.
The second domain assessed respondent attitudes toward hospice palliative care. Issues covered included 1) respondent willingness to disclose a terminal diagnosis to his/her patient; 2) willingness to see National Health Insurance cover hospice palliative care costs; 3) desire to see thanatology incorporated into the compulsory medical curriculum; 4) willingness to become a hospice palliative care volunteer; 5) willingness to serve as a terminal care physician; and 6) interest to see a formal hospice-training curriculum instituted in medical school.
The third domain gathered respondent background information.
Survey results indicated physicians have a significantly greater understanding of hospice palliative care than do medical students. Physicians were relatively more agreeable (P＜0.05) to revealing a terminal diagnosis to their patient, more in favor (P＜0.05) of paying for hospice care with National Health Insurance funds, and felt more strongly about including thanatology as part of the compulsory medical education curriculum than their medical student associates. The difference separation the 90.6% of physicians and 86.3% of medical students who agreed with the need to institutionalize a formal hospice palliative care in the medical school curriculum was not significant. These results show that hospice palliative care education should be improved and expanded for medical students and clinical physicians.

關鍵字

安寧緩和 ； 醫師 ； 醫學生 ； 知識 ； 態度

並列摘要

The professional community and society at large in Taiwan are gradually recognizing the benefits that hospice palliative care can deliver in terms of improved quality of terminal care and dignity for terminally ill patients. In order to assess the status of hospice palliative care in the medical curriculum as currently taught in Taiwan, the authors developed a study to determine a respondent’s knowledge of and attitudes toward hospice palliative. This study was then executed on a study population of medical students and practicing physicians located at a university hospital campus in central Taiwan. Medical students in their first through fifth years and physicians practicing at the university hospital were requested to participate. We designed a questionnaire covering three “domains”, which the respondents were requested fill out on their own time.
The first domain tested a respondent’s knowledge of hospice palliative care basics. It included four sections covering 1) the definition of hospice palliative care; 2) the types of diseases typically covered by hospice palliative care; 3) items of hospice palliative care; and 4) the component members of a standard hospice palliative team.
The second domain assessed respondent attitudes toward hospice palliative care. Issues covered included 1) respondent willingness to disclose a terminal diagnosis to his/her patient; 2) willingness to see National Health Insurance cover hospice palliative care costs; 3) desire to see thanatology incorporated into the compulsory medical curriculum; 4) willingness to become a hospice palliative care volunteer; 5) willingness to serve as a terminal care physician; and 6) interest to see a formal hospice-training curriculum instituted in medical school.
The third domain gathered respondent background information.
Survey results indicated physicians have a significantly greater understanding of hospice palliative care than do medical students. Physicians were relatively more agreeable (P＜0.05) to revealing a terminal diagnosis to their patient, more in favor (P＜0.05) of paying for hospice care with National Health Insurance funds, and felt more strongly about including thanatology as part of the compulsory medical education curriculum than their medical student associates. The difference separation the 90.6% of physicians and 86.3% of medical students who agreed with the need to institutionalize a formal hospice palliative care in the medical school curriculum was not significant. These results show that hospice palliative care education should be improved and expanded for medical students and clinical physicians.

並列關鍵字

hospice palliative ； physician ； medical student ； knowledge ； attitude