Cunningham Wayne, Cookson Tim
Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
N Z Med J. 2009 Aug 7;122(1300):19-28.
In January 2006 the Medical Protection Society (MPS) and Medical Assurance Society (MAS) commenced a jointly funded counselling service for stressed doctors in New Zealand. Stressed and impaired doctors may impact negatively on patient care. This study aims to investigate the service's utilisation, acceptability, and utility, and to consider whether the service may improve the delivery of health services.
Psychologist or psychiatrist providers of the service between January 2006 and July 2008 were asked to anonymously complete a questionnaire about the service. They forwarded a questionnaire to their Dr-clients requesting demographic and other data, and ideas as to how the service might be improved.
28 out of 41 providers submitted data on 39 out of 55 Dr-clients. 25 of the Dr-clients returned completed questionnaires. Most Dr-clients requiring 3 or fewer sessions suffered from work-related stress; those needing 10 or more sessions had diagnoses including depression, bipolar disease, prior sexual abuse, and personality disorders. Dr-clients valued confidentiality, choice, and independence of the provider, and funding of the service. They believed the service contributed to them remaining in or returning to work. Providers identified stress in both the work and home environment, noting that these overlapped. Respondents identified the need for greater publicity about the service.
The MPS/MAS-funded counselling service is effective and well received, but there is insufficient awareness of its availability. Stress may result in impaired performance which can impact negatively on patient care, and the provision of counselling for stressed doctors can potentially improve the delivery of health services in New Zealand.
2006年1月,医疗保护协会(MPS)和医疗保障协会(MAS)在新西兰启动了一项联合资助的针对压力过大医生的咨询服务。压力过大和身心受损的医生可能会对患者护理产生负面影响。本研究旨在调查该服务的使用情况、可接受性和效用,并考虑该服务是否可以改善医疗服务的提供。
要求2006年1月至2008年7月期间提供该服务的心理学家或精神科医生匿名填写一份关于该服务的问卷。他们向其医生客户转发了一份问卷,询问人口统计学和其他数据,以及关于如何改进该服务的想法。
41名提供者中的28名提交了55名医生客户中39名的相关数据。25名医生客户返回了填写完整的问卷。大多数需要3次或更少咨询的医生客户患有与工作相关的压力;那些需要10次或更多咨询的医生客户被诊断患有抑郁症、双相情感障碍、既往性虐待和人格障碍。医生客户重视保密性、对提供者的选择和独立性以及该服务的资金支持。他们认为该服务有助于他们继续工作或重返工作岗位。提供者指出工作和家庭环境中都存在压力,并指出两者相互重叠。受访者指出需要对该服务进行更多宣传。
由MPS/MAS资助的咨询服务有效且受到好评,但对其可用性的认识不足。压力可能导致表现受损,从而对患者护理产生负面影响,为压力过大的医生提供咨询有可能改善新西兰医疗服务的提供。