目的 探讨在广州中医药大学开展安宁疗护课程教学的效果。方法 采用量性与质性相结合的方法,2020年10月至12月,选取我校选修安宁疗护课程的66名医学生作为研究对象,在安宁疗护课程教学前后采用中文版死亡态度描绘量表(修订版)(DAP-R)和中文版佛罗梅尔特临终关怀态度量表-B表(FATCOD-B)分别对学生进行问卷调查,并于课程结束后要求学生书写学习体会。采用配对样本t检验、Wilcoxon符号秩和检验和内容分析法对调查结果和学习体会进行分析。结果 课程结束后医学生的死亡逃避得分[2.00(0.80)分比2.50(1.00)分]和死亡恐惧得分[(2.19±0.63)分比(2.43±0.65)分]均低于课前,其差异均具有统计学意义(均P<0.01);课后医学生的安宁疗护态度总分高于课前[119.00(12.00)分比107.50(12.00)分],其差异具有统计学意义(P<0.01)。学习体会分析形成“学习收获”和“课程反馈”2个主题。“学习收获”主题包括“正视死亡和思考生命”“了解并认同安宁疗护”“感悟医学人文精神”3个亚主题;“课程反馈”主题包括“对课程表示认可和满意”“建议增加实践和扩大听课学生范围”2个亚主题。结论 安宁疗护课程得到医学生的认可,有助于减轻医学生的死亡恐惧和死亡逃避心理、改善其安宁疗护态度并提高其医学人文素养。

Objective To evaluate the teaching effect of end-of-life care course in Guangzhou University of Chinese Medicine. Methods A combined quantitative and qualitative evaluation method was adopted. A total of 66 undergraduates in our university were selected as the research subjects from October to December 2020. Before and after the end-of-life care course teaching, the Chinese version of the death attitude profile-revised (DAP-R) and the Chinese version of the frommelt attitude toward care of the dying scale-form B (FATCOD-B) were used to conduct questionnaire surveys, and the students were asked to write personal learning experience after the course. Paired sample t-test, Wilconxon signed rank test and content analysis were used to analyze the data. Results After the course teaching, the scores of death avoidance[2.00 (0.80) vs. 2.50 (1.00)] and fear of death [(2.19±0.63) vs. (2.43±0.65) ] decreased significantly (all P<0.01), while the total score of hospice care attitude increased significantly [119.00 (12.00) vs. 107.50 (12.00), P<0.01]. Two themes were formed by analyzing the learning experience documents: “learning gains” and “course feedback”. The theme of “learning gains” included three sub-themes: “facing death and thinking about life”, “understanding and accepting the concept of hospice care” and “comprehending the humanistic spirit of medicine”. The theme of “course feedback” included two sub-themes: “recognition and satisfaction with the course” and “suggestions to strengthen practice training and expand the scope of students”. Conclusions End-of-life care course was recognized by medical students and can help them to reduce fear of death and death avoidance, improve hospice care attitude as well as enhance humanistic quality.