ABSTRACT
Purposes: We prospectively examined the effects of “instruction for near death” by doctors to improve communication and difficulty in end-of-life care in acute general wards. Methods: A non-randomized controlled trial was conducted to evaluate the communication between pre-treatment group and the group with and without the “instruction for near death” in the end-of-life period by Japanese version of Support Team Assessment Schedule (STAS-J). We also compared the difficulty of end-of-life care before and after the trial. Results: The “communication between professionals” in STAS-J was 0.46±0.53 in pre-treatment group (n=71), 0.18±0.39 in the instruction group (n=34) and 0.66±0.48 in the non-instruction group (n=44) (p<0.001). The “family anxiety”, the “family insight”, “communication between patient and family” and “communication professional to patient and family” in STAS-J were not significantly different between the groups. The questionnaire of difficulty of end-of-life care showed no change in both doctors and nurses. Conclusions: The “communication between professionals” was improved in the group with the “instruction for near death”. The difficulty of end-of-life care was not reduced, and it did not contribute to family anxiety and communications.
ABSTRACT
This paper reports on the practical course in health care administration that our fifth-year medical students are required to take in order to facilitate team health care. The course is intended to give students an opportunity to review health care from various viewpoints, including those of patients and ancillary medical personnel. In the present study, we used students' reports and a survey carried out immediately after the course, to measure student reactions and to examine the usefulness and possible improvements for the course.<BR>Approximately 90% of the students acknowledged value in this method of teaching, and believed their experience would help them in the future when they are doctors. Furthermore, the results of an anonymous questionnaire given to doctors with up to five years of postgraduate experience revealed that more than 60% of them supported the continuation of this type of practical course in team health care as a part of medical education.