Quill T E, Williamson P R
Department of Medicine, Genesee Hospital, Rochester, NY 14607.
Arch Intern Med. 1990 Sep;150(9):1857-61.
Many studies demonstrate that physicians in training and in practice experience considerable distress, with a high incidence of dysfunction and dissatisfaction. Little is known about the strategies employed by practicing physicians who find enjoyment and satisfaction in their work. We conducted an open-ended survey about how a group of physicians cope with common dilemmas they face today such as mistakes, death, self-care, uncertainty, patient demands, and time demands. We describe the techniques employed by those who felt they were effectively coping. Responses were organized into five general requirements for personal growth: (1) self-awareness, (2) sharing of feelings and responsibilities, (3) self-care, (4) developing a personal philosophy, and (5) nontraditional coping skills of reframing and limit setting. General descriptions of these requirements are followed by tables of specific examples from the survey. The application of these strategies to the dilemmas cited above are presented. These descriptive findings emphasize the need for training programs and governing bodies to incorporate strategies for physicians' personal growth into their priorities. The five basic areas described herein can provide a framework for formal attention to physicians' personal development.
许多研究表明，正在接受培训以及已从业的医生都经历着相当大的困扰，功能障碍和不满情绪的发生率很高。对于那些在工作中找到乐趣和满足感的执业医生所采用的策略，我们知之甚少。我们进行了一项开放式调查，内容是关于一组医生如何应对他们如今面临的常见困境，比如失误、死亡、自我保健、不确定性、患者需求以及时间需求。我们描述了那些觉得自己能有效应对困境的医生所采用的技巧。回答被归纳为个人成长的五个总体要求：（1）自我意识，（2）情感与责任的分享，（3）自我保健，（4）形成个人理念，（5）重新构建和设定界限的非传统应对技巧。在对这些要求进行总体描述之后，列出了来自调查的具体示例表。还介绍了将这些策略应用于上述困境的情况。这些描述性结果强调了培训项目和管理机构需要将医生个人成长策略纳入其优先事项。本文所述的五个基本领域可为正式关注医生个人发展提供一个框架。
