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管理式医疗从业者的精神信仰与障碍

Spiritual beliefs and barriers among managed care practitioners.

作者信息

McCauley Jeanne, Jenckes Mollie W, Tarpley Margaret J, Koenig Harold G, Yanek Lisa R, Becker Diane M

机构信息

Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.

出版信息

J Relig Health. 2005 Summer;44(2):137-46. doi: 10.1007/s10943-005-2772-2.

Abstract

PURPOSE

Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group.

METHODS

Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA.

FINDINGS

Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'.

CONCLUSIONS

Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

摘要

目的

90%的美国成年人信仰上帝,82%的人每周祈祷。大多数人希望他们的医生在医疗就诊时探讨精神层面的问题。然而,临床医生在不到20%的就诊中纳入了精神层面的讨论。我们的目标是在一个全州范围的初级保健管理式医疗集团中,衡量临床医生的信仰,并确定将精神层面因素融入患者护理中所感知到的障碍。

方法

从业者完成了一项包含30个条目的调查,内容包括人口统计学和宗教参与情况(DUREL)、患者护理中的精神层面因素(SPC)以及障碍(BAR)。我们使用频率、均值、标准差和方差分析来分析数据。

结果

临床医生有多种宗教派别(67%为基督教徒,14%为犹太教徒,11%为穆斯林、印度教徒或佛教徒,8%为不可知论者),57%为女性,24%接受过精神层面的培训。66%的人报告体验过神圣之感。95%的人认为患者的精神面貌对应对健康困难很重要,68%的人同意探讨精神层面问题是医生职责的一部分。我们管理式医疗集团中95%的人指出“时间不足”是一个重要障碍,69%的人表示“缺乏培训”,21%的人提到“担心管理层的反应”。

结论

在时间紧张环境下的管理式医疗从业者自身具有精神信仰,并认为这对患者很重要。受访者指出了时间和培训方面的障碍,影响了这些信仰的落实。将我们团队的回答与其他已发表的关于临床医生精神信仰的调查结果相比较,我们发现了类似的担忧。临床医生教育可能会克服这些障碍,并提高他们更充分满足患者在精神层面和信仰方面明确需求的能力。

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