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对收到患者投诉的新西兰医生的即时和长期影响。

The immediate and long-term impact on New Zealand doctors who receive patient complaints.

作者信息

Cunningham Wayne

机构信息

Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.

出版信息

N Z Med J. 2004 Jul 23;117(1198):U972.

Abstract

AIM

To analyse the impact of receiving a medical complaint on doctors in New Zealand.

METHODS

A questionnaire was sent to New Zealand doctors--randomly selected to include vocationally registered general practitioners, vocationally registered hospital-based specialists, and general registrants.

RESULTS

221 doctors (who had received a medical complaint) completed the questionnaire. They indicated that, in the immediate period after receiving a complaint, they experienced emotions including anger, depression, shame, guilt, and reduced enjoyment of the practice of medicine. Around one in three doctors reported reduced trust and sense of goodwill towards patients (other than the complainant), and reduction in tolerance of uncertainty and of confidence in clinical practice. In the long-term, the impact of a complaint softened--but feelings of persisting anger, reduction in trust of patients, and of reduced feelings of goodwill toward patients was reported. No differences were found between doctors practising in different vocational groups.

CONCLUSIONS

This study indicates that receiving a medical complaint has a significant negative impact on the doctor, and on important components of the doctor-patient relationship. It suggests that in the first few days and weeks after receiving a complaint, a doctor may need emotional and practising support. This study finds no evidence that the receipt of a complaint improves the delivery of patient care.

摘要

目的

分析收到医疗投诉对新西兰医生的影响。

方法

向新西兰医生发放问卷,随机选取职业注册全科医生、职业注册医院专科医生和普通注册医生。

结果

221名(收到过医疗投诉的)医生完成了问卷。他们表示,在收到投诉后的短时间内,会经历愤怒、沮丧、羞耻、内疚等情绪,以及对行医乐趣的降低。约三分之一的医生报告称,对患者(投诉者以外的)信任度和善意感降低,对不确定性的容忍度和临床实践信心下降。从长期来看,投诉的影响有所减轻,但仍有持续愤怒的感觉、对患者信任度降低以及对患者善意感降低的报告。不同职业组别的医生之间未发现差异。

结论

本研究表明,收到医疗投诉对医生以及医患关系的重要组成部分有重大负面影响。这表明在收到投诉后的头几天和几周内,医生可能需要情感和实践支持。本研究没有发现投诉能改善患者护理的证据。

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