國內外安寧緩和醫學教育現況

Current State of Hospice Palliative Medical Education in Developed Countries and Taiwan

姚建安(Chien-An Yao) ； 邱泰源(Tai-Yuan Chiu) ； 胡文郁(Wen-Yu Hu) ； 陳慶餘(Ching-Yu Chen)

《安寧療護雜誌》 9卷1期 (2004/02) Pp. 28-43

https://doi.org/10.6537/TJHPC.2004.9(1).3

摘要

照顧瀕死的病患和其家屬是醫療人員的核心專業，更是一門藝術，醫學教育有責任讓醫學院學生具備此一末期照顧的能力。緩和醫學提供在照顧瀕死病患的適切性有更多的誘因，有關末期照顧醫教育主要課程領域包括：與病人和家屬做有效的和人性化的溝通，有效處理末期疾病的病痛和其他惱人的症狀，提供全方位、可近性和高品質的安寧病護，完成病患未了的心願，了知末期疾病治療的有限性，瞭解末期照顧的倫理議題，尊重病患的價值觀，醫療團隊合作的模式，認知個對死亡和失落的態度、感覺和期望。文回顧英、美、加拿大等先進國家的末期照顧與緩和醫療的教學經驗，提出專家共同研擬的增進緩和醫療教學的基本原則，以擴大末期照顧及緩和醫療的世界觀，並檢視國內現存的末期照顧與緩和醫療教學情況，以提升醫學院學生對末期照顧與緩和醫學課程的重視。

關鍵字

緩和醫療 ； 末期照顧 ； 醫學教育

並列摘要

The care of dying patients and their family is the core professional task of medical per sonnel, and much more an art. Medical education have a responsibility to prepare the medical students to the appropriateness of caring the dying patients. The following key content areas related to end-of-life care related to undergraduate medical education include: communicating effectively and humanely with the patient and family; skillfully managing pain and other distressing symptoms commonly occurring in end-stage disease; providing accessible, comprehensive, high-quality home and hospice care, as well as other alternatives to acute hospital care; eliciting and implementing patients’ end-of-life wishes, and appreciating the limitations of treatment in advanced disease; understanding ethical issues in end-of-life care and respecting patients’ personal values; working with and inter- disciplinary team to provide comprehensive, corrdinated care; developing an awareness of one’ s own attitudes, feelings, and expectations regarding death and loss. This article reviews the experiences of undergraduate medical education about end-of-life care and palliative care in developed countries, such as United Kingdom, United States, Canada and so on. It also provides the basic principles for and extended worldwide views of enhancing undergraduate medical education in palliative care. Finally, it exhibits the present situations about undergraduate medical education about end-of-life and palliative care, emphasizes the increase of clinically professional faculty of teachers and core content of medical education curriculum.

並列關鍵字

palliative care ； end-of-life care ； medical education