Hardeman Rachel R, Burgess Diana, Phelan Sean, Yeazel Mark, Nelson David, van Ryn Michelle
Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Medical Center, Minneapolis, USA; University of Minnesota Medical School, Department of Medicine, Minneapolis, USA.
Division of Health Care Policy Research Department of Health Sciences Research, Mayo Clinic, Rochester, USA.
Patient Educ Couns. 2015 Mar;98(3):350-5. doi: 10.1016/j.pec.2014.11.013. Epub 2014 Nov 18.
To determine whether attitudes toward patient-centered care differed by socio-demographic characteristics (race, gender, socioeconomic status) among a cohort of 3191 first year Black and White medical students attending a stratified random sample of US medical schools.
This study used baseline data from Medical Student CHANGES, a large national longitudinal cohort study of medical students. Multiple logistic regression was used to assess the association of race, gender and SES with attitudes toward patient-centered care.
Female gender and low SES were significant predictors of positive attitudes toward patient-centered care. Age was also a significant predictor of positive attitudes toward patient-centered care such that students older than the average age of US medical students had more positive attitudes. Black versus white race was not associated with attitudes toward patient-centered care.
New medical students' attitudes toward patient-centered care may shape their response to curricula and the quality and style of care that they provide as physicians. Some students may be predisposed to attitudes that lead to both greater receptivity to curricula and the provision of higher-quality, more patient-centered care.
Medical school curricula with targeted messages about the benefits and value of patient-centered care, framed in ways that are consistent with the beliefs and world-view of medical students and the recruitment of a socioeconomically diverse sample of students into medical schools are vital for improved care.
在美国医学院校分层随机抽样选取的3191名一年级黑人和白人医学生队列中,确定社会人口学特征(种族、性别、社会经济地位)对以患者为中心的医疗护理态度是否存在差异。
本研究使用了来自医学生变化研究(Medical Student CHANGES)的基线数据,这是一项针对医学生的大型全国性纵向队列研究。采用多重逻辑回归分析来评估种族、性别和社会经济地位与以患者为中心的医疗护理态度之间的关联。
女性和低社会经济地位是对以患者为中心的医疗护理持积极态度的显著预测因素。年龄也是对以患者为中心的医疗护理持积极态度的显著预测因素,即年龄大于美国医学生平均年龄的学生态度更为积极。黑人与白人种族与以患者为中心的医疗护理态度无关。
新入学医学生对以患者为中心的医疗护理的态度可能会影响他们对课程的反应以及他们作为医生提供的护理质量和风格。一些学生可能倾向于持有既能使他们更易接受课程,又能提供更高质量、更以患者为中心的护理的态度。
医学院校课程中包含关于以患者为中心的医疗护理的益处和价值的针对性信息,且以与医学生的信念和世界观相一致的方式呈现,并招收社会经济背景多样的学生进入医学院校,对于改善医疗护理至关重要。