背景越来越多的社区居民生活在共病造成的生活障碍中,必须在提升姑息治疗和提供高质量的临终关怀(EOLC)的机构体制方面给予考虑。目的本文旨在深入了解全科医生为社区提供EOLC的经验,特别是关于优质护理的促进因素和障碍。设计与场所由全科医生皇家学院、英国国家医疗服务体系、玛丽居里麦克米伦网络四院开展基于网络的英国国民全科医生问卷调查。方法使用描述性统计和归纳主题分析法进行调查结果的分析。结果收到广泛分布于各实践地点的516例全科医生的回应。其中97%认为全科医学在向临终居民及其家庭提供护理起到了关键作用。数据中显现4个相互依存的主题:护理连续性——由于资源问题,诸如时间、员工数目、渐增的基层医疗工作量以及资金缺乏等问题,实现此目标比较困难;患者和家庭医生因素——存在以下挑战,包括早期识别姑息治疗的需求和认识到生命终末期,讨论护理计划的机会以及提供对家庭的支持;医疗管理——包括有效的症状控制和获得专科姑息治疗服务;专业知识培训——认识到进行培训和专业发展的必要性,从而提升关于EOLC的知识、技能和态度。结论调查结果表明,今后关于基层姑息治疗的政策、调整、实践发展和研究处于持久的优先地位。 Background An increasing number of community residents living in a life-threatening condition caused by co-morbidities must consider them in terms of institutional mechanisms that enhance palliative care and provide high quality end-of-life care (EOLC). Purpose This paper aims to gain insight into the experience of general practitioners in providing EOLC to the community, especially with regard to the promotion of quality care and barriers. Design and Locations By the Royal College of Physicians, the British National Health Service, the Mary Currie Macquarie Network Fourth Hospital conducted a web-based survey of British National GPs. Methods Descriptive statistics and thematic analysis were used to analyze the findings. The results received responses from 516 general practitioners, widely distributed in practice sites. 97% of them think that general practice plays a key role in providing care to dying inhabitants and their families. Four interdependent themes emerge in the data: Care Continuity - This is difficult to achieve due to resource issues such as time, number of employees, increasing primary health care workload, and lack of funding; patient and family physician factors - - There are challenges including early identification of the need for palliative care and recognition of end of life, opportunities for discussing care plans, and support for the family; medical management - including effective symptom control and access to specialist palliative care services; training in professional knowledge - Recognize the need for training and professional development to enhance knowledge, skills and attitudes about EOLC. Conclusions The findings of the survey show that in the future policy, adjustment, practical development and research on grassroots palliative care are a lasting priority.