Paluska S A, D'Amico F J
REX Family Practice of Cary, NC, USA.
Fam Med. 2000 Oct;32(9):612-7.
Studies have shown that female and male residents see disproportionately few patients of the opposite gender. Such an imbalance may be detrimental to the quality of residency training. This study examined residents' levels of comfort in caring for patients of the same and opposite genders and their assessments of the adequacy of the number of same- and opposite-gender patients they saw during residency training.
Data were collected from four family practice residency programs in the Midwest. All current family practice residents at the four sites surveyed were given a questionnaire asking them to rate their perceptions of the gender distributions of their patient panels and comfort with several areas of health care, some gender specific. The questionnaire used a five-point Likert scale.
Ninety-four surveys (83% response rate) were collected. Ninety-three percent of female residents reported seeing enough female patients, but only 54% reported seeing enough male patients. Seventy-six percent of male residents reported seeing enough male patients, but only 31% reported seeing enough female patients. More females than males (88% versus 48%) felt comfortable with women's health, but more males than females (70% versus 31%) felt comfortable with men's health. Male residents were significantly more comfortable than female residents in performing or managing prostate exams, testicular exams, and prostatitis. Female residents were significantly more comfortable with clinical breast exams and breast disease.
Male and female residents perceive disproportionate experiences in their exposure to patients of the opposite gender. Significant differences between male and female residents were also apparent regarding their relative comfort in managing some gender-specific health care topics. These results have implications for residency education.
研究表明,女性和男性住院医师诊治的异性患者数量极不均衡。这种失衡可能对住院医师培训质量产生不利影响。本研究调查了住院医师照料同性和异性患者时的舒适程度,以及他们对住院医师培训期间所诊治的同性和异性患者数量充足性的评估。
从美国中西部的四个家庭医学住院医师培训项目收集数据。对这四个地点所有在职的家庭医学住院医师进行问卷调查,要求他们对患者群体的性别分布认知以及在几个医疗保健领域(有些是特定性别的)的舒适度进行评分。问卷采用五点李克特量表。
共收集到94份调查问卷(回复率为83%)。93%的女性住院医师报告称诊治了足够多的女性患者,但只有54%的人报告称诊治了足够多的男性患者。76%的男性住院医师报告称诊治了足够多的男性患者,但只有31%的人报告称诊治了足够多的女性患者。对女性健康感到舒适的女性多于男性(88%对48%),但对男性健康感到舒适的男性多于女性(70%对31%)。男性住院医师在进行或管理前列腺检查、睾丸检查和前列腺炎方面比女性住院医师明显更自在。女性住院医师在进行临床乳房检查和处理乳房疾病方面明显更自在。
男性和女性住院医师在接触异性患者方面的经历不均衡。在处理一些特定性别的医疗保健话题时,男性和女性住院医师在相对舒适度方面也存在明显差异。这些结果对住院医师教育具有启示意义。