在门诊和居家护理环境中工作的跨学科专业人员对老年医学教育需求的未满足情况：PROGRAMMING COST Action 21122的一项泛欧洲调查

文献信息

中文摘要

背景： 本科老年医学教育背景各异的医疗保健专业人员（HCPs）在门诊和居家护理环境中越来越多地管理患有老年综合征的老年人。我们旨在识别参与老年人门诊照护的不同专业群体中具体的未满足老年医学教育需求。
方法： 在世界卫生组织欧洲区域，于PROGRAMMING COST Action 21122框架下，向在门诊和居家护理环境中工作的跨学科HCPs在线发放了一份横断面结构化问卷，评估其对33个老年医学领域的自我感知知识、兴趣及与实践的相关性。全球主题评分由公式（相关性+兴趣-知识）得出，作为未满足教育需求的替代指标，并采用z分数进行标准化，以便在主题和专业人员之间进行比较。
结果： 在来自41个国家的2380名应答者的总体样本中，所有主题的感知相关性和兴趣均持续高于自我报告的知识。全球主题评分位于Z分数最高五分位（提示大多数HCP群体感知到未满足的教育需求）的主题包括综合老年评估、韧性与多样性、慢性疼痛、痴呆中行为和精神症状的管理、抑郁、衰弱和认知障碍筛查。专业特异性优先事项包括：护士和言语-语言治疗师的沟通、预立医疗指示和同意能力评估；医生和药剂师的多重用药和减处方；营养师和营养评估的肌少症、吞咽困难和营养评估；心理学家和社会工作者的心理健康问题。
结论： 门诊和居家医疗保健环境中存在大量且具有专业特异性的老年医学教育差距，需要有针对性的跨学科老年医学课程。

英文摘要

BACKGROUND: Healthcare professionals (HCPs) with variable undergraduate geriatric education increasingly manage older adults with geriatric syndromes in ambulatory and home care settings. We aimed to identify specific unmet geriatric educational needs of the different professional groups involved in older people's outpatient care.
METHODS: A cross-sectional structured questionnaire assessing self-perceived knowledge, interest and relevance to practice regarding 33 geriatric domains was disseminated online to interdisciplinary HCPs working in ambulatory and home care settings in the World Health Organization European Region, in the context of the PROGRAMMING COST Action 21122. A global topic score, derived from the formula (relevance + interest-knowledge) served as a surrogate of unmet educational needs, and was standardised using z-scores to enable comparisons across topics and professionals.
RESULTS: In the overall sample of 2380 responders from 41 countries, perceived relevance and interest consistently exceeded self-reported knowledge across all topics. Global topic scores ranking in the top Z-score quintile, indicative of perceived unmet educational needs for most HCP groups, included comprehensive geriatric assessment, resilience and diversity, chronic pain, management of behavioral and psychiatric symptoms in dementia, depression, frailty and cognitive impairment screening. Profession-specific priorities included communication, advance healthcare directives and assessment of capacity to consent for nurses and speech-language therapists, polypharmacy and deprescribing for medical doctors and pharmacists, sarcopenia, dysphagia and nutritional assessment for dieticians and mental health problems for psychologists and social workers.
CONCLUSIONS: Substantial and profession-specific gaps in geriatric education exist in ambulatory and home healthcare settings, which warrant targeted interdisciplinary geriatric courses.