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医疗改革对基层医疗医师工作相关态度和焦虑的影响。

The influence of health care reforms on work-related attitudes and anxieties of primary care physicians.

机构信息

Department of Family Medicine, Faculty of Medicine, Dokuz Eylul University, 35340 Inciralti-Izmir, Turkey.

出版信息

Medicina (Kaunas). 2011;47(11):623-8.

Abstract

BACKGROUND AND OBJECTIVE

Reforming primary healthcare services has been the core agenda of health policies of the developing countries in accordance with the recommendations of the World Health Organization. In Turkey, the Transformation in Health Project brings along many changes in all aspects of primary health care services, such as organization and financing of services and employment of healthcare workers. The aim of this study was to determine the effects of health care reforms on primary care physicians working in Izmir.

MATERIAL AND METHODS

A questionnaire and an anxiety scale were applied to a sample of primary care physicians in Izmir in 2007 and 2009. The questionnaire consisted of questions about demographic characteristics and expressions regarding the effect of reforms on physicians organized on a 7-point Likert scale. The State-Trait Anxiety Inventory was used as an anxiety scale.

RESULTS

The mean scores given by physicians working in family health centers were significantly higher than those of physicians working in public institutions. The score for "My responsibilities are well defined" statement given by physicians working in family health centers decreased significantly in the second survey. The necessity of reforms in the health care system and primary care health services was more significantly favored by physicians working in family health centers. Persistent anxiety of physicians working in community health centers was significantly higher in both surveys.

CONCLUSIONS

Our study showed that health reforms had a substantial impact on work-related attitudes and anxieties of primary care physicians, and this effect was maintained over time.

摘要

背景与目的

根据世界卫生组织的建议,改革基层医疗服务一直是发展中国家卫生政策的核心议程。在土耳其,《卫生转型项目》带来了基层医疗服务各个方面的许多变化,如服务的组织和融资以及卫生工作者的就业。本研究旨在确定医疗改革对伊兹密尔从事初级保健的医生的影响。

材料与方法

2007 年和 2009 年,我们向伊兹密尔的初级保健医生样本发放了问卷和焦虑量表。问卷包含有关人口统计学特征和对改革对医生影响的表述的问题,这些表述按 7 点李克特量表组织。状态-特质焦虑量表被用作焦虑量表。

结果

在家庭健康中心工作的医生的平均得分明显高于在公共机构工作的医生。在第二次调查中,家庭健康中心工作的医生对“我的职责定义明确”这一说法的评分显著下降。家庭健康中心工作的医生更明显地赞成医疗保健系统和初级保健服务的改革必要性。在两次调查中,社区卫生中心工作的医生持续存在的焦虑明显更高。

结论

我们的研究表明,卫生改革对初级保健医生的工作相关态度和焦虑产生了重大影响,这种影响随着时间的推移而持续。

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