Investigation Of Cognition,Attitude And Behavior Of Medical Staff To Palliative Care Grading Service And Analysis Of Influencing Factors

Objective: To investigate the status quo of cognition,attitude and behavior of hospice care grading diagnosis and treatment among medical staff,and analyze the influencing factors,so as to provide reference for health administrative departments to explore the hospice care grading diagnosis and treatment mode,and medical institutions to formulate corresponding training plans and implement training.Methods: 562 cases of National Hospice training classes from December 2020 to February 2021 were selected by convenience sampling method.The general information questionnaire and the cognition,attitude and behavior questionnaire of hospice grading diagnosis and treatment were used to investigate the medical staff before the training.IBM SPSS22.0 software was used for statistical analysis,and mean(M),standard deviation(SD)and constituent ratio were used for statistical description;Univariate analysis of variance was used to compare the scores of attitude and behavior of hospice care grading among medical staff with different characteristics;Multiple stepwise regression analysis was used to explore the influencing factors of attitude and behavior of hospice care grading diagnosis and treatment among medical staff.Results:(1)in the cognitive dimension,64.9% of the respondents thought that the hospital community family referral was the best referral mechanism;91.9% of the patients thought that the doctor-patient-family should decide the patient’s referral;In cognitive item 5 and 7,the correct response rate of referral related knowledge was 4.7% and 34%,respectively;61.7% of the medical staff thought that pain control was the most basic symptom management skill;The cognition of service function orientation of medical institutions at all levels is roughly consistent with the hierarchical diagnosis and treatment policy.(2)The average score was(4.36±0.59).The last three items are: to what extent do you agree that hospice care grading diagnosis and treatment is the condition of hospital grade evaluation(4.06 ±0.92);To what extent do you agree that end-stage patients first visit primary medical institutions(4.10 ±0.99);To what extent do you agree that medical staff are the main negotiators of hospice care grading(4.15 ±0.87);The results of univariate analysis showed that there were significant differences in the scores of professional title,whether to participate in hospice care training,whether to have care experience of end-stage patients,and whether to have relevant referral system in the unit.The results of multiple stepwise regression analysis showed that professional title,whether the unit has the relevant referral system and the Department are the main factors influencing the attitude of hospice care grading diagnosis and treatment(P < 0.05).(3)The average score of hospice care grading diagnosis and treatment behavior of medical and nursing staff was(3.13 ±0.89).The last three items are: whether your unit or department has signed a contract with a family doctor to provide home-based home-based services for end-stage patients(2.18 ± 1.34);Will your unit or department conduct consultation and Discussion on patients with difficult hospice care through remote consultation,so as to solve the physical,psychological,social and spiritual needs of patients(2.77 ± 1.36);Does your unit or department provide grief counseling for the family members of end-stage patients(2.94±1.30)points;Univariate analysis showed that there were significant differences in the scores of different professional titles,types of medical institutions,hospice care referral experience and related referral system(P < 0.05).The results of multiple stepwise regression analysis showed that gender and related referral system were the main factors influencing the behavior of graded diagnosis and treatment of hospice care.Conclusion:(1)the cognitive level of hospice care grading diagnosis and treatment needs to be improved.(2)The attitude of medical staff to hospice care grading diagnosis and treatment was more positive;Professional title,whether the unit has the relevant referral system and department are the independent factors that affect the attitude of hospice care grading diagnosis and treatment of medical staff.(3)The behavior of hospice care and classified diagnosis and treatment of medical staff needs to be further improved;Gender and whether the unit has the relevant referral system are the independent factors that affect the hospice hierarchical diagnosis and treatment behavior of medical staff.The signing system of family doctors needs to be improved,the referral channel of hospice care needs to be unblocked,and the grief counseling of patients’ family members and the psychological and spiritual needs of patients should be strengthened in the graded diagnosis and treatment of hospice care.