Department of Sociology of Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Fam Pract. 2011 Feb;28(1):75-81. doi: 10.1093/fampra/cmq070. Epub 2010 Sep 10.
There is relatively little research on affective influences on physician behaviour, especially on prescribing and referrals. Affects include transitory moods and lasting emotions.
We explored physician perceptions of the impact of four mood states on perceived rates of five behaviours: talking with patients, prescribing medications and referrals for laboratory tests, diagnostic tests and specialists. We also examined whether burnout modified the impact of moods on behaviour.
A total of 188 family physicians responded anonymously to a self-reporting questionnaire that assessed the perceived rate of behaviours when in a positive, negative, tired and nervous mood and burnout level.
Five analyses of variance with repeated measures on mood states and contrast analyses computed the effects of mood and burnout on the behaviours. The mood factor was found significant for each of the behaviours, in all P < 0.001. The respondents reported that on good mood compared with negative mood days, they talked more, prescribed less and referred less. The burnout factor was also significant: high compared with low burnout physicians had higher perceived rates of all referral behaviours. Significant mood × burnout interactions indicated that the effects of mood were stronger among high compared with low burnout physicians.
The physicians perceived that their moods had different effects on different behaviours: the negative mood decreased talking and increased prescribing and referral behaviours and vice versa for the positive mood. Burnout intensified the effects of moods. The incremental effects of negative moods and burnout may impair quality of health care and may be costly to health services.
关于情感对医生行为的影响,尤其是对处方和转诊的影响,研究相对较少。情感包括短暂的情绪和持久的情绪。
我们探讨了医生对四种情绪状态对五种行为的感知影响的看法:与患者交谈、开处方和转介进行实验室检查、诊断检查和专家。我们还检查了倦怠是否改变了情绪对行为的影响。
共有 188 名家庭医生匿名回答了一份自我报告问卷,该问卷评估了他们在积极、消极、疲倦和紧张情绪以及倦怠程度下五种行为的感知率。
对情绪状态进行了五次方差分析和重复测量,并对情绪和倦怠对行为的影响进行了对比分析。在所有 P < 0.001 的情况下,情绪因素对每种行为都有显著影响。受访者报告说,与消极情绪相比,他们在积极情绪时更多地交谈,更少地开处方和转介。倦怠因素也很重要:与低倦怠相比,高倦怠医生对所有转诊行为的感知率更高。显著的情绪×倦怠交互作用表明,情绪对高倦怠医生的影响比低倦怠医生更强。
医生认为他们的情绪对不同的行为有不同的影响:消极情绪减少了交谈,增加了开处方和转诊行为,而积极情绪则反之。倦怠加剧了情绪的影响。负面情绪和倦怠的增量效应可能会损害医疗服务质量,并可能对卫生服务造成代价高昂。