Mejía Raul, Diego Andrea, Alemán María, Maliandi María del Rosario, Lasala Fernando
Programa de Medicina Interna General (PMIG), Departamento de Medicina, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires.
Medicina (B Aires). 2005;65(4):295-301.
Because previous investigations show that mistreatment during residency is frequent we undertook this research to assess the prevalence of psychological abuse, physical violence and sexual harassment in residency training programs and the professional status of perpetrators. Through a literature review and a previous qualitative study we developed a self-administered questionnaire. Thirteen events that could be experienced by residents and ten possible perpetrators were described in the questionnaire. Residents were asked to record whether they had experienced these events, at least once, and who was responsible. This survey was distribuided among the residents from three hospitals of Buenos Aires city. A total of 322 residents answered the questionnaire (55% women) 72% of whom worked in clinical programs, 22% in surgical programs, and 6% in diagnostic programs. Mistreatment was reported by 89% of the residents. On average each resident recorded 8 different episodes of mistreatment, such as being criticized for not completing administrative work (75%), being shouted at (64%), being humiliated in public (57%), sexual harassment (10%), being exposed to pornographic material without permission (7%), being hit or pushed (15%), suffering racial or religious discrimination (10%). The most common perpetrators were senior residents (26%), chief resident (19%), attending physicians (14%), and nurses (8%). Mistreatment and abuse are commonly experienced by residents in training programs. A multidisciplinary approach is needed to address this problem in the training environment.
由于先前的调查显示住院医师培训期间的虐待行为很常见,我们开展了这项研究,以评估住院医师培训项目中心理虐待、身体暴力和性骚扰的发生率以及施虐者的职业身份。通过文献综述和先前的定性研究,我们编制了一份自填式问卷。问卷中描述了住院医师可能经历的13种事件以及10种可能的施虐者。要求住院医师记录他们是否至少经历过一次这些事件以及谁应为此负责。这项调查在布宜诺斯艾利斯市三家医院的住院医师中进行。共有322名住院医师回答了问卷(55%为女性),其中72%在临床项目工作,22%在外科项目工作,6%在诊断项目工作。89%的住院医师报告遭受过虐待。平均每位住院医师记录了8起不同的虐待事件,例如因未完成行政工作而受到批评(75%)、被大声呵斥(64%)、在公共场合受到羞辱(57%)、性骚扰(10%)、未经许可接触色情材料(7%)、被殴打或推搡(15%)、遭受种族或宗教歧视(10%)。最常见的施虐者是高年级住院医师(26%)、总住院医师(19%)、主治医生(14%)和护士(8%)。住院医师在培训项目中普遍经历过虐待和侵害。需要采取多学科方法来解决培训环境中的这个问题。