Study On The Situation And Countermeasures Of Palliative Care In Tianjin

Objective:Through field visits to Tianjin palliative care(PC)institutions and questionnaires for palliative care practitioners,understand the current status of palliative care in Tianjin,and understand the understanding of palliative care by medical personnel working in palliative care institutions Based on the analysis of the existing problems in the development of Tianjin’s palliative care,it proposes corresponding countermeasures against the problems and lays the foundation for further improving the content of palliative care.Method:A self-designed questionnaire survey was conducted.Through telephone interviews with 61 community health service centers in Tianjin,16 health institutions were visited on the spot,and medical personnel in 8 health institutions were interviewed in depth and analyzed.The survey included the names and basic settings of medical institutions.For example,beds,department settings and staffing.Meanwhile,a questionnaire survey was conducted among medical staff.The questionnaire included basic information of medical personnel,gender,age,working life,work nature,religious belief,educational level,marital status and so on.Questionnaires were used to investigate the sources of medical knowledge,past experience of relieving medical education,attitudes towards analgesics and relieving medical knowledge among medical staff.SPSS 23.0 was used to input data for statistical analysis.Result:1.Tianjin palliative care mode mainly includes:(1)integrated medical and nursing wards at various levels of health institutions,(2)integrated Chinese and Western medicine departments at various levels of hospitals,(3)oncology and pain departments at all levels of hospitals2.The composition of Tianjin palliative care team:(1)general practitioners,(2)doctor of integrative Chinese and western medicine,(3)oncologist,(4)nurses,(5)social workers,(6)psychiatrists3.In this study,60 community health service centers were interviewed by telephone.Among them,6 health institutions were hospitalized with mild medical treatment,1 health institutions provided home based palliative care,and 31 health institutions had no palliative care.4.Field visits were conducted to 16 health institutions with inpatient wards,and11 to provide palliative care for hospitalization.5.This study visited a total of 8 hospitals,all providing palliative care hospitalization,no home palliative medical care,outpatient palliative care.The name of the institution is permanently integrated Chinese and Western medicine,integrated medical and nursing wards,there is no officially named palliative care or hospice care.There are 384 beds in 8 institutions,55 practicing physicians and 90 practicing nurses.6.Results of a questionnaire survey of medical staff:(1)In this survey,there are 12 males,accounting for 16.2%,62 females,accounting for 83.8%,doctors accounting for 35.1%,and nurses 64.9%.The age is concentrated between 20-40 years old,accounting for 81.1%.The majority is 63%.(2)33.3% of medical staff said that they have never heard of palliative care,9.8%of them have never heard of hospice care,and 16.2% of medical staff have learned professional palliative medical knowledge through school education.(3)20.3% of medical staff believe that palliative care is hospice care,and 4.1%of medical staff believe that palliative care is to give up treatment.(4)5.2% of the medical staff realized that palliative care can be applied in the early stage of the disease.(5)Professional palliative medical education experience is related to medical personnel’s understanding of palliative medical knowledge,and doctors have a higher degree of awareness of palliative care than nurses.Conclusion:1.Although there are many primary palliative care facilities in Tianjin,there is no systematic system,and there is no specialized medical treatment.Opiates are not easy to obtain.The survey found that the development of palliative care in Tianjin is at the level of 3a,which is 2 times worse than the level of 4a development inChina.At the same time,outpatient clinics and acute palliative care units were carried out in general hospitals.Establish a reasonable referral mechanism to achieve a standardized path.2.Tianjin’s palliative care team has a single structure and lacks a professional team.It needs to draw attention from all walks of life,increase financial support,carry out systematic professional training for the existing relaxation medical teams,and publicize education and training in other industries to ease medical reserve personnel.3.The development of palliative care needs to improve infrastructure allocation,strengthen personnel training and expand public awareness on the basis of the existing relaxation medical service.It is suggested that the advance care planning should be evaluated and the medical knowledge should be eased.4.School education can help improve the cognition level of medical personnel in palliative care.We should appeal to ease palliative medicine as an independent medical profession in school education.5.It is necessary to carry out mild medical needs screening for patients with chronic diseases in community,carry out mild medical propaganda for the masses,and establish a correct concept of death,which is conducive to the early integration of palliative care and disease treatment.