Division of Medical and Dental Education, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK.
Med Educ. 2011 Dec;45(12):1241-50. doi: 10.1111/j.1365-2923.2011.04079.x. Epub 2011 Oct 13.
Doctors do not follow guidance when managing their own health and illness. This behaviour may start at medical school. This study aimed to investigate whether inappropriate responses to illness are an issue for medical students and, if so, to identify the determinants of students' responses to illness.
We undertook a qualitative study using framework analysis to explore the views of medical students at two UK medical schools.
Eight focus groups carried out with 35 medical students identified four main themes in students' cognitions about their intended behaviour: not using usual patient pathways; informal consultation; self-treatment, and keeping going when ill. The reasons or assumptions underlying these beliefs referred to: time and resources, including wider issues such as responsibility to colleagues; stigma and attitudes of others including regulatory bodies; beliefs about themselves in terms of taking on the patient role and issues relating to coping and self-sufficiency; the behaviour and attitudes of peers; patient safety considerations; patients' views about sick doctors; barriers to accessing care; the ease of self-care, and uncertainty about ability to self-care.
Many different factors related to medical students' beliefs about illness. Conflicts occur among student needs to be seen as competent and dedicated to medicine, to protect personal privacy, to maintain convenience, and to seek care appropriately in order to be fair on colleagues and protect the public. These conflicts were complicated by perceptions of the system, peers and doctors as unsupportive of ill health except by facilitating informal access to care. Beliefs underlying intentions are similar between doctors and medical students, but further research is needed to fully determine how and when these beliefs are formed.
医生在管理自身健康和疾病时并未遵循指导原则。这种行为可能始于医学院。本研究旨在调查医学生是否存在对疾病处理不当的问题，如果存在，那么确定学生对疾病反应的决定因素。
我们采用框架分析法进行了一项定性研究，以探讨两所英国医学院学生的观点。
在对 35 名医学生进行的 8 个焦点小组中，确定了学生对预期行为的认知中的四个主要主题：不使用常规患者路径；非正式咨询；自我治疗，以及在患病时继续坚持。这些信念背后的原因或假设涉及：时间和资源，包括同事责任等更广泛的问题；耻辱感和他人的态度，包括监管机构；对自己承担患者角色的信念以及与应对和自给自足相关的问题；同龄人的行为和态度；患者安全考虑；患者对生病医生的看法；获得护理的障碍；自我护理的便利性，以及对自我护理能力的不确定性。
与医学生对疾病的信念相关的因素有很多种。学生的需求之间存在冲突，需要被视为有能力且专注于医学，以保护个人隐私，保持便利，并为了公平对待同事和保护公众而适当地寻求护理。这些冲突因对系统、同龄人以及医生的看法而变得复杂，他们认为除了促进非正式获得护理外，对健康状况并不支持。医生和医学生的意图背后的信念相似，但需要进一步研究以确定这些信念是如何以及何时形成的。
