Puertas E Benjamín, Rivera Tamara Y
Pan American Health Organization, Tegucigalpa, Honduras.
Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.
Rev Panam Salud Publica. 2016 Nov;40(5):309-317.
To 1) describe patterns of specialty choice; 2) investigate relationships between career selection and selected demographic indicators; and 3) identify salary perception, factors that influence career choice in primary care, and factors that influence desired location of future medical practice.
The study used a mixed-methods approach that included a cross-sectional questionnaire survey applied to 234 last-year medical students in Honduras (September 2014), and semi-structured interviews with eight key informants (October 2014). Statistical analysis included chi-square and factor analysis. An alpha level of 0.05 was used to determine significance.
In the qualitative analysis, several codes were associated with each other, and five major themes emerged. Primary care careers were the preferred choice for 8.1% of students, who preferred urban settings for future practice location. The perceived salary of specialties other than primary care was significantly higher than those of general practitioners, family practitioners, and pediatricians (P < 0.001). Participants considered "making a difference," income, teaching, prestige, and challenging work the most important factors influencing career choice. Practice in ambulatory settings was significantly associated with a preference for primary care specialties (P = < 0.05). Logistic regression analysis found that factors related to patient-based care were statistically significant for selecting primary care (P = 0.006). The qualitative analysis further endorsed the survey findings, identifying additional factors that influence career choice (future work option; availability of residency positions; and social factors, including violence). Rationales behind preference of a specialty appeared to be based on a combination of ambition and prestige, and on personal and altruistic considerations.
Most factors that influence primary care career choice are similar to those found in the literature. There are several factors distinctive to medical students in Honduras-most of them barriers to primary care career choice.
1）描述专业选择模式；2）调查职业选择与选定人口统计学指标之间的关系；3）确定薪资认知、影响初级保健职业选择的因素以及影响未来医疗执业理想地点的因素。
本研究采用混合方法，包括对洪都拉斯234名医学专业最后一年学生（2014年9月）进行的横断面问卷调查，以及对8名关键信息提供者进行的半结构化访谈（2014年10月）。统计分析包括卡方检验和因子分析。采用0.05的显著性水平来确定显著性。
在定性分析中，几个编码相互关联，出现了五个主要主题。8.1%的学生首选初级保健职业，他们倾向于在城市地区进行未来执业。除初级保健外的其他专业的预期薪资明显高于全科医生、家庭医生和儿科医生（P<0.001）。参与者认为“有所作为”、收入、教学、声望和具有挑战性的工作是影响职业选择的最重要因素。门诊环境中的执业与对初级保健专业的偏好显著相关（P =<0.05）。逻辑回归分析发现，与基于患者的护理相关的因素在选择初级保健方面具有统计学显著性（P = 0.006）。定性分析进一步证实了调查结果，确定了影响职业选择的其他因素（未来工作选择；住院医师职位的可获得性；以及社会因素，包括暴力）。对某一专业偏好背后的理由似乎基于抱负和声望的结合，以及个人和利他主义的考虑。
大多数影响初级保健职业选择的因素与文献中发现的因素相似。洪都拉斯医学生有几个独特的因素——其中大多数是初级保健职业选择的障碍。
