The true feelings of dying patients in China:a meta-synthesis of qualitative studies / 中华护理杂志

Objective To conduct a systematic review on the need and experience of patients in end of life and provide evidence-based guidance for delivery of end-of-life care in hospital and community settings. Methods Two Chinese (CBM and CNKI) and four English relevant databases (PsycINFO,MEDLINE,EMbase and CINAHL) were in-cluded to retrieve literatures on Chinese dying patients' needs and experience between inception and August 2016. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. The searching results were synthesized by employing Integrating Methods. Results Seventy-five findings were extracted from 9 qualified studies. The 75 findings were sequently integrated into 5 categories and finally 2 synthesized re-sults were summarized from the 5 categories. Integration result 1:under the sufferings from both physical and psy-chological aspects,dying patients require support from both family and society. Integration result 2:although death is acceptable for patients,they still hope for dignity and goals of life. Conclusion Needs of patients in end-of-life should be understood and respected. Reasonable and effective measures need to be taken to meet their needs and improve their quality of life.

Perception and attitudes of medical students toward communication, chronic disease and death.

Background: Medical students of today’s world found difficulty in communication when they faced with dying patients, how they would feel, what are their perception about caring of patients with chronic disease. These are often unspoken and neglected issues. Methods: It was a cross-sectional comparative questionnaire based survey of the 2nd year medical students and interns. Students were evaluated using a questionnaire consisting of 15 Likert type statements. Results: Completed questionnaire received from 89 out of 100 students. All students strongly agreed upon the commutation with patients. Interns (37.03%) were strongly disagreed (p=0.001) on not curing the patient is a failure of doctors. Interns (32.58%) were significantly more likely to be less worried (p<0.01) about death of the patient and to indicate cancer is a non-curable disease (p<0.001) when compared to 2nd MBBS. Students from both the groups distressed, while communicating with dying patients and relatives of dying patients. Conclusion: Perception of students regarding caring of chronically ill-patients and death related issues needs improvement. We believe that integrating different teaching strategies and training programs regarding this issue should begin at early stages of undergraduate medical curriculum.