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日本东北部临床培训医院中医师对跨专业协作的认知

Physician's Perceptions of Interprofessional Collaboration in Clinical Training Hospitals in Northeastern Japan.

作者信息

Minamizono Sachiko, Hasegawa Hitoshi, Hasunuma Naoko, Kaneko Yoshihiro, Motohashi Yutaka, Inoue Yuji

机构信息

Department of Health Care Policy, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Japan ; Department of Community Medicine and Primary Care Development, Akita University School of Medicine, 1-1-1 Hondo, Akita, Japan.

出版信息

J Clin Med Res. 2013 Oct;5(5):350-5. doi: 10.4021/jocmr1474w. Epub 2013 Aug 5.

Abstract

BACKGROUND

Effective and efficient interprofessional collaboration (IPC) is needed between departments in a healthcare setting. Although Japanese physicians are expected to provide leadership in IPC, it has been suggested that their perception of IPC is more negative than among other healthcare professionals. The purpose of this study was to clarify Japanese physician's perceptions of IPC and what factors influenced their views.

METHODS

This cross-sectional study surveyed 732 medical doctors at a university hospital and six foundation hospitals in a prefecture located in Tohoku district, northeastern Japan. Those hospitals were approved for delivery of postgraduate clinical training. Physician's perceptions of IPC were investigated for three items, namely providing patient-centered care, preventing medical accidents, and improving the quality of medical care. A total of 409 doctors who were engaged in clinical practice, responded adequately to the survey. Factors associated with negative perceptions towards IPC among physicians were analyzed using a logistic regression model.

RESULTS

The proportion of negative perceptions of IPC for providing patient-centered care, preventing medical accidents, and improving the quality of medical care were 41.1%, 34.0% and 33.7%, respectively. Negative perceptions of IPC for providing patient-centered care were associated with older age (50 + years; odds ratio (OR): 2.73; 95% confidence interval (CI): 1.11 - 6.68) and a lower frequency of interprofessional meetings (no meetings; OR: 2.95; 95%CI: 1.43 - 6.08). Negative perceptions of IPC for preventing medical accidents were associated with a lower frequency of interprofessional meetings (no meetings, OR: 3.23; 95%CI: 1.58 - 6.62). Negative perceptions of IPC for improving the quality of medical care were associated with middle age (40 - 49 years, OR: 2.93; 95%CI: 1.20 - 7.12) and a lower frequency of interprofessional meetings (no meetings; OR: 2.75; 95%CI: 1.34 - 5.66).

CONCLUSIONS

Physician's negative perceptions of IPC in our study were associated with age and a lower frequency of interprofessional meetings. Our findings suggest that effective regular interprofessional meetings serve to share information about patients, and to allow physicians to understand each other better, which should have a positive impact on the quality of patient-centered care.

摘要

背景

在医疗环境中,各科室之间需要有效且高效的跨专业协作(IPC)。尽管日本医生被期望在跨专业协作中发挥领导作用,但有研究表明,他们对跨专业协作的看法比其他医疗专业人员更为消极。本研究的目的是阐明日本医生对跨专业协作的看法以及影响他们观点的因素。

方法

本横断面研究对日本东北部东北地区一所大学医院和该地区六家基础医院的732名医生进行了调查。这些医院被批准提供研究生临床培训。调查了医生对跨专业协作的三个方面的看法,即提供以患者为中心的护理、预防医疗事故和提高医疗质量。共有409名从事临床实践的医生对调查做出了充分回应。使用逻辑回归模型分析了与医生对跨专业协作的负面看法相关的因素。

结果

在提供以患者为中心的护理、预防医疗事故和提高医疗质量方面,对跨专业协作持负面看法的比例分别为41.1%、34.0%和33.7%。对提供以患者为中心的护理的跨专业协作持负面看法与年龄较大(50岁及以上;优势比(OR):2.73;95%置信区间(CI):1.11 - 6.68)以及跨专业会议频率较低(无会议;OR:2.95;95%CI:1.43 - 6.08)有关。对预防医疗事故的跨专业协作持负面看法与跨专业会议频率较低(无会议,OR:3.23;95%CI:1.58 - 6.62)有关。对提高医疗质量的跨专业协作持负面看法与中年(40 - 49岁,OR:2.93;95%CI:1.20 - 7.12)以及跨专业会议频率较低(无会议;OR:2.75;95%CI:1.34 - 5.66)有关。

结论

在我们的研究中,医生对跨专业协作的负面看法与年龄和跨专业会议频率较低有关。我们的研究结果表明,有效的定期跨专业会议有助于分享患者信息,并使医生更好地相互理解,这应该会对以患者为中心的护理质量产生积极影响。

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