Gardiner Maria, Kearns Hugh, Tiggemann Marika
School of Psychology, Flinders University, Bedford Park, South Australia, Australia.
Aust J Rural Health. 2013 Jun;21(3):183-9. doi: 10.1111/ajr.12033.
To determine the relationship between cognitive behavioural coaching, the well-being of rural general practitioners (GPs), their intentions to leave and actual leaving of rural general practice.
Quasi-experimental study utilising an intervention group of rural GPs and deidentified data for a baseline group and a control group consisting of the remaining population of rural GPs in South Australia.
Rural general practice.
Rural GPs in South Australia: intervention group (n = 69), baseline group (n = 205) and control group (n = 312).
A 9-hour cognitive behavioural coaching program.
MAIN OUTCOME MEASURE(S): Rural doctor distress, intention to leave rural general practice and actual retention rate of rural GPs.
GPs who underwent cognitive behavioural coaching had lower rural doctor distress scores (mean = 24.50; confidence interval, 21.71-27.29) than the baseline group (mean = 28.63; confidence interval, 27.08-30.17). Before coaching, 81% of rural GPs in the intervention group had considered leaving general practice, which reduced to 40% after coaching (χ(2) (2) = 16.31, P < .001). Over a 3-year period, 94% of the coaching group remained in general practice compared with 80% of the control group (χ(2) (1) = 4.89, P = 0.027).
Cognitive behavioural coaching reduced the stress levels of rural GPs who self-identified the need for managing stress and reduced their intention to leave rural general practice. Further, despite initially being more stressed compared with the general population of rural GPs, more GPs from the coaching group remained in rural general practice.
确定认知行为辅导与农村全科医生（GP）的幸福感、他们离开农村全科医疗的意向以及实际离开农村全科医疗之间的关系。
采用准实验研究，将农村全科医生分为干预组，并利用去识别化数据形成基线组以及由南澳大利亚州其余农村全科医生组成的对照组。
农村全科医疗。
南澳大利亚州的农村全科医生：干预组（n = 69）、基线组（n = 205）和对照组（n = 312）。
一个时长9小时的认知行为辅导项目。
农村医生的困扰程度、离开农村全科医疗的意向以及农村全科医生的实际留任率。
接受认知行为辅导的全科医生的农村医生困扰得分（均值 = 24.50；置信区间，21.71 - 27.29）低于基线组（均值 = 28.63；置信区间，27.08 - 30.17）。辅导前，干预组中81%的农村全科医生曾考虑离开全科医疗，辅导后这一比例降至40%（χ(2)(2) = 16.31，P < .001）。在3年期间，辅导组中有94%的人仍从事全科医疗，而对照组这一比例为80%（χ(2)(1) = 4.89，P = 0.027）。
认知行为辅导降低了自我认定有压力管理需求的农村全科医生的压力水平，并降低了他们离开农村全科医疗的意向。此外，尽管最初与农村全科医生总体相比压力更大，但辅导组中有更多的全科医生留在了农村全科医疗岗位。
