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华人生死学
摘要
目的 评估生死教育干预对实习医学生死亡恐惧及安宁疗护知识的影响。方法 2025年3月至2025年5月，在上海交通大学医学院附属新华医院对50名实习医学生实施为期4周、12学时的生死教育干预，包括讲座、案例分析、小组讨论、角色扮演、实地参观及阅读反思。使用改良Collett-Lester死亡恐惧量表和自编安宁疗护知识问卷，在干预前后进行测评，并收集学生评价。结果 干预后，实习医学生“害怕自己死亡”得分从（17.5±0.7）分降至（14.1±8.6）分（t=2.653，P=0.026），“害怕自己濒死”得分从（21.0±4.2）分降至（16.5±8.9）分（t=3.216，P=0.011），安宁疗护知识得分从（73.2±8.5）分提升至（80.1±5.9）分（t=-3.975，P=0.002）。86%的学生认为课程内容丰富，92%的学生认为增强医疗实践信心。定性分析提炼出“课程形式认可”“内容深度需求”“实践应用期待”“情感支持需求”4个主题，显示学生认可多样化教学方法，但希望增加沟通技巧培训和情感支持机制。结论 短期生死教育干预有助于降低实习医学生面对自身死亡的恐惧，提升安宁疗护知识水平。
Abstract
Objective To evaluate the effect of life-and-death education intervention on death anxiety and palliative care knowledge among medical interns. Methods Fifty medical interns received a 4-week (12-hour) life-and-death education intervention including lectures, case analysis, group discussion, role-play, field visits and reading reflection. The revised Collett-Lester Fear of Death Scale (FODS, 28 items) and a self-designed palliative care knowledge questionnaire (41 items) were administered before and after the intervention. Student evaluations were also collected. Results After the intervention, the scores for “fear of own death” decreased from 17.5±0.7 to 14.1±8.6 (t=2.653, P=0.026), “fear of own dying” decreased from 21.0±4.2 to 16.5±8.9 (t=3.216, P=0.011), and palliative care knowledge scores increased from 73.2±8.5 to 80.1±5.9 (t=-3.975, P=0.002). Eighty-six percent of students agreed that the course content was rich. Ninety-two percent of students believed it enhanced their confidence in medical practice. Qualitative analysis identified four themes: “recognition of teaching methods”, “need for content depth”, “expectation for practical application”, and “need for emotional support”, students show recognition of diverse teaching methods, but hope for increased communication skills training and emotional support mechanisms. Conclusion Short-term life-and-death education intervention may help reduce medical interns’ anxiety about their own death and improve palliative care knowledge. However, this single-group design with limited sample size requires cautious interpretation, and long-term effects need further verification.
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