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Palliative Care Training for Consultation-Liaison Psychiatry Fellows: A National Survey Project

机译：咨询 - 联络精神病学家研究员的姑息治疗培训：国家调查项目

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Background: Provision of palliative care is part of the standard of care for patients with serious, life-limiting medical illnesses. Patients in the palliative care setting have high rates of psychiatric co-morbidity. However, integration of mental health care into palliative care remains a significant gap. With appropriate training, consultation-liaison (C-L) psychiatrists are well-positioned to improve integration of mental health into palliative care. Purpose: To understand current palliative care training practices for C-L psychiatry fellows in the United States. Method: We invited all U.S. C-L psychiatry fellowship program directors to participate in a 17-item online structured survey aimed at understanding palliative care training in their fellowship programs. Results: 37161 (61%) of C-L psychiatry fellowship program directors responded to the survey. Eighty-six percent of programs provide some palliative care didactics, but the topics covered vary widely. Programs are closely split between offering a required, elective, or no clinical palliative care experiences. Only about half (45%) of programs identify formal opportunities for interaction between palliative care and C-L psychiatry fellows. Program directors identified topics such as goals-of-care discussions, systems issues in endof-life care, and pain management as important for fellows to learn. Barriers to teaching these topics included time, lack of teaching faculty, and disciplinary siloes. Conclusions: Although C-L psychiatry fellowship program directors identify a number of key teaching topics in palliative care for C-L psychiatry fellows, there are wide discrepancies in the depth and content of existing palliative care didactic and clinical experiences in C-L psychiatry fellowships.
机译：背景：提供姑息治疗是严重、危及生命的疾病患者护理标准的一部分。在姑息治疗环境中的患者有很高的精神病合并发病率。然而，将心理健康护理纳入姑息治疗仍然是一个巨大的差距。通过适当的培训，会诊联络（C-L）精神病医生能够更好地将心理健康融入姑息治疗。目的：了解美国C-L精神病学研究员目前的姑息治疗培训实践。方法：我们邀请所有美国C-L精神病学研究金项目负责人参加一项17项在线结构化调查，旨在了解他们研究金项目中的姑息治疗培训。结果：37161名（61%）的C-L精神病学奖学金项目负责人对调查做出了回应。86%的项目提供了一些姑息治疗教学法，但涵盖的主题差异很大。这些项目在提供必要的、可选的或不提供临床姑息治疗体验之间有着密切的区别。只有大约一半（45%）的项目确定了姑息治疗和C-L精神病学研究员之间的正式互动机会。项目负责人指出，护理讨论的目标、endof life care中的系统问题和疼痛管理等主题对研究员来说非常重要。教授这些主题的障碍包括时间、师资缺乏和学科孤岛。结论：尽管C-L精神病学研究金项目负责人为C-L精神病学研究金确定了一些关于姑息治疗的关键教学主题，但C-L精神病学研究金现有姑息治疗教学和临床经验的深度和内容存在很大差异。

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