Fankhänel Thomas, Rascher Anja, Thiel Carolin, Schulz Katrin, Klement Andreas
Sektion Allgemeinmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Deutschland.
Sektion Allgemeinmedizin, Medizinische Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Deutschland.
Z Evid Fortbild Qual Gesundhwes. 2016;112:36-42. doi: 10.1016/j.zefq.2016.03.013. Epub 2016 Apr 5.
Only a few general practitioners (GPs) are committed to screen their patients for alcohol consumption and, in case of excessive alcohol consumption conduct by a brief intervention according to WHO recommendations. Apart from inadequate compensation and work load, another barrier identified by the GPs was their uncertainty about how to deal with affected patients. Most German universities presently spend no more than 90minutes lecture time on addiction medicine teaching. Our research aims to investigate the question whether medical studies and advanced medical education increases the role security of medical students and physicians and their commitment to implementing alcohol screening and brief intervention. Moreover, we will explore whether lack of therapeutic commitment can be related to lack of role security. Questionnaires were administered to pre-clinical and clinical medical students as well as senior house officers. Role security and therapeutic commitment of students and senior house officers were assessed using the Alcohol and Alcohol Problems Questionnaire (SAAPPQ) subscales "Role Security" and "Therapeutic Commitment". Analysis was based on 367 questionnaires. As expected, senior house officers reported more Role Security than clinical medical students who showed a higher level of Role Security than pre-clinical medical students. No differences could be found for Therapeutic Commitment. An association between Role Security and Therapeutic Commitment was only revealed for clinical medical students. Medical studies and advanced medical education can increase students' and senior house officers' Role Security to treat patients with excessive alcohol consumption, but not Therapeutic Commitment. Moreover, no association between Role Security and Therapeutic Commitment could be found for senior house officers. Hence, it may be assumed that educational activities aiming to increase Role Security do not promote the development of motivational aspects such as Therapeutic Commitment to the management of patients with excessive alcohol intake.
只有少数全科医生致力于对患者进行酒精消费筛查,若发现患者饮酒过量,则根据世界卫生组织的建议进行简短干预。除了报酬不足和工作量大之外,全科医生指出的另一个障碍是他们不确定如何应对受影响的患者。目前,德国大多数大学在成瘾医学教学上的授课时间不超过90分钟。我们的研究旨在调查医学学习和进阶医学教育是否会增强医学生和医生的角色安全感以及他们实施酒精筛查和简短干预的积极性。此外,我们将探讨缺乏治疗积极性是否与缺乏角色安全感有关。我们对临床前和临床医学生以及住院医师进行了问卷调查。使用酒精及酒精问题问卷(SAAPPQ)的“角色安全感”和“治疗积极性”分量表评估学生和住院医师的角色安全感和治疗积极性。分析基于367份问卷。正如预期的那样,住院医师报告的角色安全感高于临床医学生,而临床医学生的角色安全感又高于临床前医学生。在治疗积极性方面未发现差异。仅在临床医学生中发现角色安全感与治疗积极性之间存在关联。医学学习和进阶医学教育可以增强学生和住院医师治疗饮酒过量患者的角色安全感,但不能增强治疗积极性。此外,在住院医师中未发现角色安全感与治疗积极性之间存在关联。因此,可以假设旨在增强角色安全感的教育活动不会促进诸如对饮酒过量患者管理的治疗积极性等动机方面的发展。