Dunn Laura B, Green Hammond Katherine A, Roberts Laura Weiss
Department of Psychiatry & Department of Urology, University of California, San Francisco, San Francisco, California, USA.
Acad Med. 2009 Feb;84(2):242-50. doi: 10.1097/ACM.0b013e31819397e2.
The authors sought to understand the health issues and care-seeking practices reported by residents and explored the extent to which fear of academic jeopardy, stigma, and being the subject of discussion by colleagues may affect residents' care-seeking.
Residents at the University of New Mexico Health Sciences Center were surveyed in 2000-2001 regarding avoidance or postponement of obtaining necessary health care, responses of others to absences, and perceptions of jeopardy to training status if a supervisor learned of a specific condition. Responses were analyzed via repeated-measures MANOVA.
Of 217 surveys, 155 were returned (71% response rate). Concerns with mental health, pain, minor infections, or relationship, sleep-related, fatigue, or gynecological/urological problems were expressed by 26% to 43% of residents. Concerns of potential jeopardy if a director or supervisor learned about personal health issues were strongest for problems with drugs/alcohol, moderately high for HIV, and moderate for mental health, eating-related problems, cancer, and STDs. Residents had sometimes avoided seeking care, and 18% had often avoided or delayed care-seeking; women delayed or avoided care more often than men. More frequent avoidance of seeking care was associated with poorer self-rated mental and physical health and greater health concerns.
Residents at times postpone or avoid seeking care. Time and scheduling difficulties influence the ability to obtain care. Perceptions of potential academic jeopardy, stigma, and reactions of colleagues may affect residents' attitudes and care-seeking. Further inquiry is essential to understand how extensively these factors may influence the well-being of residents.
作者试图了解住院医师报告的健康问题和寻求医疗服务的行为，并探讨对学业受影响的恐惧、耻辱感以及成为同事讨论对象的情况可能在多大程度上影响住院医师寻求医疗服务。
2000 - 2001年对新墨西哥大学健康科学中心的住院医师进行了调查，内容包括避免或推迟获得必要的医疗服务、他人对缺勤的反应以及如果上级得知特定病情对培训状态受影响的看法。通过重复测量多元方差分析对回答进行分析。
在217份调查问卷中，155份被收回（回复率71%）。26%至43%的住院医师表示担心心理健康、疼痛、轻微感染、人际关系、睡眠相关问题、疲劳或妇科/泌尿科问题。如果主任或上级得知个人健康问题，对药物/酒精问题潜在受影响的担忧最为强烈，对艾滋病毒问题的担忧程度中等偏高，对心理健康、饮食相关问题、癌症和性传播疾病的担忧程度为中等。住院医师有时会避免寻求医疗服务，18%的人经常避免或推迟寻求医疗服务；女性比男性更常推迟或避免寻求医疗服务。更频繁地避免寻求医疗服务与自我评定的较差心理和身体健康状况以及更多的健康担忧相关。
住院医师有时会推迟或避免寻求医疗服务。时间和日程安排困难会影响获得医疗服务的能力。对潜在学业受影响的认知、耻辱感以及同事的反应可能会影响住院医师的态度和寻求医疗服务的行为。进一步探究对于了解这些因素可能在多大程度上影响住院医师的健康状况至关重要。
