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基层医疗住院医师在与患者临床接触中对灵性与宗教的看法:美国中西部一所教学机构的研究

Beliefs of primary care residents regarding spirituality and religion in clinical encounters with patients: a study at a midwestern U.S. teaching institution.

作者信息

Luckhaupt Sara E, Yi Michael S, Mueller Caroline V, Mrus Joseph M, Peterman Amy H, Puchalski Christina M, Tsevat Joel

机构信息

Department of Internal Medicine, University of Cincinnati Medical Center, Veterans Healthcare System of Ohio, USA.

出版信息

Acad Med. 2005 Jun;80(6):560-70. doi: 10.1097/00001888-200506000-00011.

Abstract

PURPOSE

To assess primary care residents' beliefs regarding the role of spirituality and religion in the clinical encounter with patients.

METHOD

In 2003, at a major midwestern U.S. teaching institution, 247 primary care residents were administered a questionnaire adapted from that used in the Religion and Spirituality in the Medical Encounter Study to assess whether primary care house officers feel they should discuss religious and spiritual issues with patients, pray with patients, or both, and whether personal characteristics of residents, including their own spiritual well-being, religiosity, and tendency to use spiritual and religious coping mechanisms, are related to their sentiments regarding spirituality and religion in health care. Simple descriptive, univariate, and two types of multivariable analyses were performed.

RESULTS

Data were collected from 227 residents (92%) in internal medicine, pediatrics, internal medicine/pediatrics, and family medicine. One hundred four (46%) respondents felt that they should play a role in patients' spiritual or religious lives. In multivariable analysis, this sentiment was associated with greater frequency of participating in organized religious activity (odds ratio [OR] 1.55, 95% confidence interval [CI] 1.20-1.99), a higher level of personal spirituality (OR 1.05, 95% CI 1.02-1.08), and older resident age (OR 1.11, 95% CI 1.02-1.21; C-statistic 0.76). In general, advocating spiritual and religious involvement was most often associated with high personal levels of spiritual and religious coping and with the family medicine training program. Residents were more likely to agree with incorporating spirituality and religion into patient encounters as the gravity of the patient's condition increased (p < .0001).

CONCLUSIONS

Approximately half of primary care residents felt that they should play a role in their patients' spiritual or religious lives. Residents' agreement with specific spiritual and religious activities depended on both the patient's condition and the resident's personal characteristics.

摘要

目的

评估基层医疗住院医师对于灵性与宗教在临床医患交流中所起作用的看法。

方法

2003年,在美国中西部一所主要的教学机构,对247名基层医疗住院医师进行了一项问卷调查,该问卷改编自《医疗交流中的宗教与灵性研究》中使用的问卷,旨在评估基层医疗住院医师是否觉得他们应该与患者讨论宗教和灵性问题、与患者一起祈祷,或者两者都做,以及住院医师的个人特征,包括他们自身的精神幸福感、宗教信仰程度,以及使用精神和宗教应对机制的倾向,是否与他们在医疗保健中对灵性和宗教的看法有关。进行了简单描述性、单变量和两种多变量分析。

结果

收集了来自内科、儿科、内科/儿科和家庭医学专业的227名住院医师(92%)的数据。104名(46%)受访者认为他们应该在患者的精神或宗教生活中发挥作用。在多变量分析中,这种看法与参与有组织宗教活动的频率更高(优势比[OR]1.55,95%置信区间[CI]1.20 - 1.99)、个人灵性水平更高(OR 1.05,95% CI 1.02 - 1.08)以及住院医师年龄较大(OR 1.11,95% CI 1.02 - 1.21;C统计量0.76)相关。总体而言,倡导精神和宗教参与最常与个人较高水平的精神和宗教应对以及家庭医学培训项目相关。随着患者病情严重程度的增加,住院医师更有可能同意将灵性和宗教融入医患交流中(p < .0001)。

结论

大约一半的基层医疗住院医师认为他们应该在患者的精神或宗教生活中发挥作用。住院医师对特定精神和宗教活动的认同既取决于患者的病情,也取决于住院医师的个人特征。

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