Jarvis John, Frizelle Frank
Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch.
N Z Med J. 2006 Jun 23;119(1236):U2026.
Research looking at the effect of complaints on senior medical staff has shown that while there is important information to be gained from patient criticisms of medical care, they are often not well received by doctors. There is no information on the effects of complaints on junior medical staff and those undergoing vocational training in New Zealand. The aim of this study is to assess the impact of complaints on trainees in general surgery.
A questionnaire was devised and sent to all advanced general surgical trainees in New Zealand. There were four sections to the questionnaire covering background, professional life, family life, and personal health. The scale was semantically anchored at not applicable, strongly agree, agree, neither, disagree, and strongly disagree.
Following electronic mailings of the questionnaire at three different times, 35 of 58 (60%) questionnaires were returned of which 21 (60%) of the respondents had received at least one major complaint; 10 (29%) indicated they had experienced one complaint; 4 (11%) reported 2 complaints; 3 (9%) had received 3 complaints; and 1 (3%) reported 4 complaints. None of the respondents believed that the complaint had improved their surgical training. Thirty-one (86%) respondents believed that the complaint had made them practice more defensively; 13 (38%) felt that the complaint had a negative effect of future doctor-patient relationships; and 15 (43%) felt a lack of trust with such relationships. Twenty-three (67%) felt decreased enjoyment with their training and 18 (53%) felt the complaint had a negative effect on their family. Twenty-seven (78%) felt depressed over the complaint, with 18 (52%) feeling a lack of support and being alone with the experience.
Trainees receiving complaints find them difficult to deal with; they incur an emotional cost on the doctor and possible future doctor patient relationships. Thus it is important that trainee doctors receive support and guidance throughout this difficult and stressful event.
针对投诉对资深医务人员影响的研究表明,虽然患者对医疗护理的批评能提供重要信息,但医生往往对此反应不佳。目前尚无关于投诉对新西兰初级医务人员及接受职业培训人员影响的相关信息。本研究旨在评估投诉对普通外科实习生的影响。
设计了一份问卷并发送给新西兰所有高级普通外科实习生。问卷有四个部分,涵盖背景、职业生活、家庭生活和个人健康。量表在语义上以不适用、强烈同意、同意、无意见、不同意和强烈不同意为锚点。
在三个不同时间通过电子邮件发送问卷后,共收回58份问卷中的35份(60%),其中21名(60%)受访者至少收到过一次重大投诉;10名(29%)表示经历过一次投诉;4名(11%)报告收到过2次投诉;3名(9%)收到过3次投诉;1名(3%)报告收到过4次投诉。没有受访者认为投诉改善了他们的外科培训。31名(86%)受访者认为投诉使他们采取了更具防御性的做法;13名(38%)觉得投诉对未来医患关系产生了负面影响;15名(43%)觉得对这种关系缺乏信任。23名(67%)感到培训的乐趣减少,18名(53%)觉得投诉对他们的家庭产生了负面影响。27名(78%)因投诉而感到沮丧,18名(52%)觉得缺乏支持,独自面对这一经历。
收到投诉的实习生觉得难以应对;投诉给医生带来情感成本,并可能影响未来的医患关系。因此,在这一艰难且压力巨大的事件中,实习医生获得支持和指导非常重要。