Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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The Necessity for End-of-Life Care Education: A Preliminary Analysis with Interns at Two University Hospitals

임종돌봄에 대한 교육의 필요성: 2개 대학병원의 인턴을 대상으로 예비 분석

  • Kim, Do Yeun (Department of Internal Medicine, Dongguk University Ilsan Hospital) ;
  • Kim, Kyong-Jee (Department of Medical Education, Dongguk University School of Medicine) ;
  • Shin, Sung Joon (Department of Internal Medicine, Dongguk University Ilsan Hospital) ;
  • Kwon, Ivo (Department of Medical Education, Ewha Womans University School of Medicine) ;
  • Nam, Eun Mi (Department of Internal Medicine, Seoul National University Hospital) ;
  • Heo, Dae Seog (Department of Internal Medicine, Ewha Womans University School of Medicine) ;
  • Lee, Soon Nam (Department of Internal Medicine, Ewha Womans University School of Medicine)
  • 김도연 (동국대학교 일산병원 내과) ;
  • 김경지 (동국대학교 의과대학 의학교육학교실) ;
  • 신성준 (동국대학교 일산병원 내과) ;
  • 권복규 (이화여자대학교 의과대학 의학교육학교실) ;
  • 남은미 (서울대학교병원 내과) ;
  • 허대석 (이화여자대학교 의학전문대학원 내과학교실) ;
  • 이순남 (이화여자대학교 의학전문대학원 내과학교실)
  • Received : 2017.03.28
  • Accepted : 2017.05.24
  • Published : 2017.06.01
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Abstract

Purpose: This study was performed to explore the current state of end-of-life (EoL) care education provided to new interns at two university hospitals. Methods: A questionnaire was given to incoming interns (N=64). The levels of acquired knowledge and experience of clinical observation were measured. Seven areas for self-assessment questions were identified and used to analyze the interns' attitudes towards EoL-related education and practice. Results: On average, participants learned five elements (nine in total) from EoL-related classes and two (seven in total) from clinical observation. The most frequently educated element was how to deliver bad news (96.9%) in the classroom setting and how to control physical symptoms (56.5%) in clinical observation. Less than 20% received training on EoL care communication, including discussion of advanced directives. Compared with participants who had no EoL training, those who had EoL training showed positive attitudes in all seven categories regarding overall satisfaction, interest and preparedness in relation to EoL-care classes and practice. Conclusion: Although interns are responsible for caring of dying patients, their EoL training in classroom and clinical settings was very insufficient. Further research should be conducted to establish an education system that provides sufficient knowledge and training on EoL care.

목적: 본 연구는 2개 대학병원의 인턴을 대상으로 임종돌봄에 대한 교육 현황을 파악하고자 하였다. 방법: 2개 대학병원의 64명의 인턴들에게 구조화된 설문지를 배포하여 임종돌봄 교과과정의 강의습득 경험과 임상견학 경험 여부를 확인하였다. 또한 임종돌봄 관련 교육이나 진료에 대한 태도를 평가할 수 있는 7개의 자가평가질문을 파악하였다. 결과: 임종돌봄 교과과정 강의 습득과 임상실습 견학 개수의 평균은 각각 5개(총 영역 개수: 9)와 2개(총 영역 개수: 7)였다. 가장 많이 교육받은 항목은 나쁜 소식 전하기(96.9%)였고 임상실습 동안 가장 많이 견학한 항목은 신체증상 조절(56.5%)였다. 그러나 사전연명의료의향서를 포함한 의사소통 영역에 대한 경험은 20% 미만이었다. 임종돌봄 단독 교과목 교육군은 그렇지 않은 군과 비교하여 임종돌봄 교과과정에 대한 만족도, 관심도, 준비됨의 7가지 항목에서 모두 유의하게 긍정적인 답변을 하였다. 결론: 본 연구는 임종돌봄이 필요한 환자를 진료해야 하는 인턴들이 임종돌봄에 대한 교과과정 습득과 임상경험이 매우 부족함을 관찰하였다. 추후 국내 임종돌봄 교육에 대한 의과대학교육의 전체적인 상황을 파악하여 관련된 적절한 지식과 기술을 연마하는 교육체계를 세울 필요가 있다.

Keywords

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