全科医生士气对患者护理满意度的影响：一项横断面研究。

The impact of general practitioner morale on patient satisfaction with care: a cross-sectional study.

作者信息

McKinstry Brian, Walker Jeremy, Porter Mike, Fulton Colette, Tait Ashley, Hanley Janet, Mercer Stewart

机构信息

Community Health Sciences, University of Edinburgh, 20 W Richmond Street, Edinburgh, UK.

出版信息

BMC Fam Pract. 2007 Sep 28;8:57. doi: 10.1186/1471-2296-8-57.

DOI:10.1186/1471-2296-8-57

PMID:17903255

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2072947/

Abstract

BACKGROUND

The association between stress and morale among general practitioners (GP) is well documented. However, the impact of GP stress or low morale on patient care is less clear. GPs in the UK now routinely survey patients about the quality of their care including organizational issues and consultation skills and the General Practice Assessment Questionnaire (GPAQ) is widely used for this purpose. We aimed to see if there was a relationship between doctor morale as measured by a validated instrument, the Morale Assessment in General Practice Index (MAGPI) and scores in the GPAQ.

METHODS

All GPs in Lothian, Scotland who were collecting GPAQ data were approached and asked to complete the MAGPI. Using an anonymised linkage system, individual scores on the MAGPI were linked to the doctors' GPAQ scores. Levels of association between the scores were determined by calculating rank correlations at the level of the individual doctor. Hypothesised associations between individual MAGPI and GPAQ items were also assessed.

RESULTS

276 of 475 GPs who were approached agreed to complete a MAGPI questionnaire and successfully collected anonymous GPAQ data from an average of 49.6 patients. There was no significant correlation between the total MAGPI score and the GPAQ communication or enablement scale. There were weak correlations between "control of work" in the MAGPI scale and GPAQ items on waiting times to see doctors (r = 0.24 p < 0.01). Doctors who perceived that their patients viewed them negatively also scored lower on individual communication, accessibility and continuity of care GPAQ items.

CONCLUSION

This study showed no relationship between overall GP morale and patient perception of performance. There was a weak relationship between patients' perceptions ofquality and doctors' beliefs about their workload and whether patients value them. Further research is required to elucidate the complex relationship between workload, morale and patients' perception of care.

摘要

背景

全科医生（GP）的压力与士气之间的关联已有充分记录。然而，全科医生的压力或低落士气对患者护理的影响尚不清楚。英国的全科医生现在经常就护理质量对患者进行调查，包括组织问题和咨询技巧，通用实践评估问卷（GPAQ）广泛用于此目的。我们旨在探讨通过一种经过验证的工具——全科医学士气评估指数（MAGPI）衡量的医生士气与GPAQ得分之间是否存在关系。

方法

我们联系了苏格兰洛锡安地区所有收集GPAQ数据的全科医生，并要求他们完成MAGPI。通过匿名链接系统，将MAGPI的个人得分与医生的GPAQ得分相联系。得分之间的关联程度通过计算个体医生层面的等级相关性来确定。还评估了MAGPI与GPAQ各项目之间的假设关联。

结果

475名被联系的全科医生中有276名同意完成MAGPI问卷，并成功从平均49.6名患者那里收集了匿名的GPAQ数据。MAGPI总分与GPAQ沟通或支持量表之间没有显著相关性。MAGPI量表中的“工作控制”与GPAQ中关于看医生等待时间的项目之间存在弱相关性（r = 0.24，p < 0.01）。那些认为患者对自己评价负面的医生在GPAQ的个人沟通、可及性和护理连续性项目上得分也较低。