中国全科医学 ›› 2021, Vol. 24 ›› Issue (34): 4330-4335.DOI: 10.12114/j.issn.1007-9572.2021.00.223

所属专题: 社区卫生服务最新研究合集 安宁疗护专题研究

• 专题研究 • 上一篇    下一篇

国外全科医生参与居家安宁疗护实践经验与启示

黎雯霞,马珺*,杜雪   

  1. 400016重庆市,重庆医科大学公共卫生与管理学院 医学与社会发展研究中心 健康领域社会风险预测治理协同创新中心
    *通信作者:马珺,副教授,硕士生导师;E-mail:fairlily1117@163.com
  • 出版日期:2021-12-05 发布日期:2021-12-05

General Practitioners' Participation in Home-based Hospice Care in Foreign Countries:Practice Experience and Enlightenment 

LI Wenxia,MA Jun*,DU Xue   

  1. School of Public Health and Management/Research Center for Medicine and Social Development/Innovation Center for Social Risk Governance in Health,Chongqing Medical University,Chongqing 400016,China
    *Corresponding author:MA Jun,Associate professor,Master supervisor;E-mail:fairlily1117@163.com
  • Published:2021-12-05 Online:2021-12-05

摘要: 安宁疗护可提高患者在生命末期的生活质量,减轻患者和家属的身心痛苦。近年来国外在该领域的发展中积累了较多的经验,且全科医生作为居家安宁疗护的主要提供者也已成为其突出特点。然而安宁疗护在我国发展起步较晚,基础建设薄弱,全科医生参与安宁疗护的研究尚处于起步阶段,面对日益增长的疗护需求,须加快安宁疗护服务体系的建设。本文通过分析、总结美国、英国和澳大利亚等国家全科医生参与安宁疗护的经验,结合我国现状和特点,提出相应的启示性建议,包括:可建立多层次的安宁疗护服务体系,辅以活动为基础的支付模式和医疗保障;制定居家安宁疗护服务指南,明确全科医生执业范围和责任划分;加强全科医生安宁疗护教育培训,提高疗护人员技能水平;利用有效宣传模式提高预立护理计划在医患双方的认知度,促进安宁疗护在我国的长足发展。

关键词: 临终关怀和姑息治疗护理, 全科医生, 居家安宁疗护

Abstract: Hospice care improves a patient's quality of life at the end of life via reducing his physical and mental sufferings,and also relieves the physical and mental burden endured by his family members. In recent years,rich experience in developing hospice care has been accumulated in other countries,with a prominent feature of GPs being primary providers of home-based hospice care. However,given that the development of hospice care in China started late,the development of relevant essential projects is weak,and the research on GPs involvement in hospice care is still in its initial stage,it is necessary for China to accelerate the construction of a hospice care system to meet the increasing demand for hospice care. In view of this,we analyzed and summarized the useful experience of GPs participating in hospice care in the US,the UK,Australia and other countries,then put forward insightful suggestions in accordance with current status and characteristics of China's hospice care system:establishing a multi-level hospice care system,supplemented by activity-based payment and health insurance coverage;formulating guidelines for home-based hospice care services with the clarified scope of practice and responsibilities of GPs;strengthening hospice care education and training for GPs and nurses to improve their competencies;raising the awareness of advance care planning among doctors and patients with effective publicity tools to promote the long-term development of hospice care in China.

Key words: Hospice and palliative care nursing, General practitioners, Home palliative care