目的 了解医学院校不同专业学生临床实习前对死亡与临终关怀的态度,为优化在校临终关怀教育提供参考。方法 采用中文版死亡态度描绘量表(修订版)和中文版佛罗梅尔特临终关怀态度量表-B表,对广州中医药大学即将进入临床实习的中医学和护理学专业191名本科学生进行有关死亡和临终关怀态度的调查,并对不同专业学生的调查结果进行比较。采用t检验和Pearson相关分析对调查结果进行统计学处理。结果 中医学专业学生的死亡态度描绘量表各维度得分从高到低依次为中立接受(3.95±0.55)分、趋近接受(2.64±0.60)分、死亡逃避(2.64±0.69)分、死亡恐惧(2.59±0.61)分和逃离接受(2.45±0.72)分,护理学专业学生得分从高到低为中立接受(4.10±0.44)分、死亡恐惧(2.76±0.71)分、死亡逃避(2.59±0.71)分、趋近接受(2.56±0.55)分和逃离接受(2.47±0.80)分,2个专业学生中立接受维度得分的差异具有统计学意义(t=-2.019,P=0.045)。中医学专业学生的临终关怀态度量表总得分为(103.98±7.63)分,护理学专业学生为(109.66±9.06)分,两者差异具有统计学意义(t=-4.678,P<0.001)。2个专业学生的临终关怀态度得分与死亡恐惧得分均呈负相关,与中立接受得分均呈正相关。结论 虽然护理学专业学生对死亡与临终关怀的态度优于中医学专业学生,但是2个专业学生对死亡与临终关怀的态度均有较大提升空间。因此,医学院校应当加强临终关怀教育的力度,以帮助学生改善死亡观和提高对临终关怀的认识。
Objective To describe medical students' attitudes toward death and hospice care before internship, in order to provide the evidence for optimizing end-of-life care education at school.Methods The total of 191 baccalaureate students majored in Chinese medicine and nursing in Guangzhou University of Chinese Medicine just before clinical practice were investigated and compared using 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). Independent t-test and Pearson product-moment correlation were used to analyze the data.Results For students of Chinese medicine, the scores of the 5 dimensions of death attitude are neutral acceptance (3.95±0.55), approach acceptance (2.64±0.60), death avoidance (2.64±0.69), fear of death (2.59±0.61), and escape acceptance (2.45±0.72). The scores of nursing students are neutral acceptance (4.10±0.44), fear of death (2.76±0.71), death avoidance (2.59±0.71), approach acceptance (2.56±0.55), and escape acceptance (2.47±0.80). Neutral acceptance score of nursing students is statistically higher than students of Chinese medicine (t=-2.019,P=0.045). The total score of hospice care attitude of students majored in Chinese medicine and nursing are (103.98±7.63) and (109.66±9.06), and the score of nursing students is statistically higher (t=-4.678,P<0.001). The hospice care attitude score is negatively correlated with fear of death scores, and positively correlated with neutral acceptance score in medical students.Conclusions Despite nursing students' attitudes toward death and hospice care are superior to students of Chinese medicine, there is a big space to improve both groups of students. Therefore, it is imperative for medical colleges and universities to strengthen end-of-life care education, so as to help medical students improving their view of death and understanding of hospice care.
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