填补空白：评估保加利亚医学教育体系中死亡证明的能力

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论证。在保加利亚，公民死亡登记程序受一系列复杂法规的制约。虽然国际和国内的指导方针应该是统一的，但实际经验表明，医务工作者的技能存在差距，尤其是在涉及先前医疗干预或系统脆弱性的情况下。本研究的目的是评估毕业班医学生和新手医生是否准备应对错综复杂的死亡证明程序（包括问卷调查结果），以及评价为死者家属提供文书工作和尸检程序的准确度。这对国家卫生统计会有现实意义。

该研究的目的。本研究的作者对医学生和新手医生对与死亡有关的各种事态发展的准备情况进行了综合评估，并且将他们的能力与经验丰富的专业人员进行了比较，从而制定出实用的建议，主要针对新手医务人员。这项研究没有评估确定死因的准确度。该研究的目的是提高教育水平，编写信息手册和课程调整建议，以改善医学课程的培训。

材料与方法。本研究采用混合方法对六年级医学生和执业医生（包括急诊和全科医生）进行了问卷调查。数据收集是使用纸质和数字问卷进行的。这确保匿名性并符合了道德标准。使用参数（t检验）和非参数（卡方检验）标准进行统计分析的结果为制定实用建议和培训材料提供了依据。

结果。共有143名参与者被纳入了该研究。其中41%的人对院外死亡证明表示担忧。约44%的人表示，他们熟悉死亡证明的规则。学生们表现出良好的理论背景，但缺乏实践技能。值得注意的是，74%的医生从未接受过正规的死亡认证培训。在死亡证明书的办理、期限和通知主管当局的程序方面存在差异。

结论。该研究结果表明，不同专业的医生在死亡证明方面的做法存在差异。文件记录、时间安排和死亡通知是最具挑战性的问题。这项研究强调了在这一领域开展更多培训的必要性，尤其是对医学生而言。急诊医生的培训水平更高。医学生和新手医生急需加强这方面的培训。将这些主题纳入课程、提供专业课程和分发教材的过程可以大大提高学习效果。进一步的研究需要评估死因登记的质量和准确度。死因登记的质量和准确度对于公共卫生服务的医疗统计和法律程序非常重要。这证实死亡证明做法在公共和行政方面的重要性。

作者简介

Yanko G. Kolev

Medical University of Pleven; Department of Forensic Medicine, District hospital MBAL

Email: drforensic@gmail.com
ORCID iD: 0000-0003-2958-1702

MD, Dr. Sci. (Med.), Assistant Lecturer

保加利亚, Pleven; Gabrovo

Tsvetelina Valentinova

Medical University of Pleven

编辑信件的主要联系方式.
Email: tsvm2002@yahoo.com
ORCID iD: 0000-0001-7095-5572

MD, Assistant Professor

保加利亚, Pleven

Petko H. Stefanovski

Medical University of Pleven

Email: p.stefanovski@gmail.com
ORCID iD: 0000-0002-9676-3605

MD, Assistant Professor

保加利亚, Pleven

Elka Tumbeva

Medical University of Pleven

Email: e.tumbeva@abv.bg
ORCID iD: 0000-0003-0292-7347

Assistant Lecturer

保加利亚, Pleven

Nikolay M. Mirochnik

Medical University of Pleven

Email: nikolaimirochnik@gmail.com
ORCID iD: 0009-0004-0115-9985
保加利亚, Pleven

Preslav-Geo Y. Kolev

Medical Faculty of Sofia University

Email: preslavgeo1@gmail.com
ORCID iD: 0009-0008-7679-1124
保加利亚, Sofia

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补充文件

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2. Appendix 1. Brochure (two pages) on practical advice for death determination and certification “Quick guide to Death Certification”
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3. Appendix 1. Brochure (two pages) on practical advice for death determination and certification “Quick guide to Death Certification”

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4. Appendix 1. Brochure (two pages) on practical advice for death determination and certification “Quick guide to Death Certification”

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