Iannello Paola, Mottini Anna, Tirelli Simone, Riva Silvia, Antonietti Alessandro
a Department of Psychology - Research Unit on Decision-making Processes in Emergency Medicine , Catholic University of the Sacred Heart , Milan , Italy.
b University of Milan , Department of Health Sciences , Milan , Italy.
Med Educ Online. 2017;22(1):1270009. doi: 10.1080/10872981.2016.1270009.
Medical practice is inherently ambiguous and uncertain. The physicians' ability to tolerate ambiguity and uncertainty has been proved to have a great impact on clinical practice. The primary aim of the present study was to test the hypothesis that higher degree of physicians' ambiguity and uncertainty intolerance and higher need for cognitive closure will predict higher work stress. Two hundred and twelve physicians (mean age = 42.94 years; SD = 10.72) from different medical specialties with different levels of expertise were administered a set of questionnaires measuring perceived levels of work-related stress, individual ability to tolerate ambiguity, stress deriving from uncertainty, and personal need for cognitive closure. A linear regression analysis was performed to examine which variables predict the perceived level of stress. The regression model was statistically significant [R = .32; F(10,206) = 8.78, p ≤ .001], thus showing that, after controlling for gender and medical specialty, ambiguity and uncertainty tolerance, decisiveness (a dimension included in need for closure), and the years of practice were significant predictors of perceived work-related stress. Findings from the present study have some implications for medical education. Given the great impact that the individual ability to tolerate ambiguity and uncertainty has on the physicians' level of perceived work-related stress, it would be worth paying particular attention to such a skill in medical education settings. It would be crucial to introduce or to empower educational tools and strategies that could increase medical students' ability to tolerate ambiguity and uncertainty.
JSQ: Job stress questionnaire; NFCS: Need for cognitive closure scale; PRU: Physicians' reactions to uncertainty; TFA: Tolerance for ambiguity.
医疗实践本质上具有模糊性和不确定性。事实证明，医生容忍模糊性和不确定性的能力对临床实践有很大影响。本研究的主要目的是检验以下假设：医生对模糊性和不确定性的不耐受程度越高，对认知闭合的需求越高，工作压力就越大。对来自不同医学专业、具有不同专业水平的212名医生（平均年龄 = 42.94岁；标准差 = 10.72）进行了一组问卷调查，以测量他们感知到的工作相关压力水平、个人容忍模糊性的能力、不确定性带来的压力以及个人对认知闭合的需求。进行线性回归分析以检验哪些变量能够预测感知到的压力水平。回归模型具有统计学意义[R = 0.32；F(10,206) = 8.78，p ≤ 0.001]，这表明在控制了性别和医学专业之后，模糊性和不确定性容忍度、果断性（认知闭合需求中的一个维度）以及执业年限是感知到的工作相关压力的重要预测因素。本研究的结果对医学教育有一些启示。鉴于个人容忍模糊性和不确定性的能力对医生感知到的工作相关压力水平有很大影响，在医学教育环境中特别关注这种技能是值得的。引入或加强能够提高医学生容忍模糊性和不确定性能力的教育工具和策略至关重要。
JSQ：工作压力问卷；NFCS：认知闭合需求量表；PRU：医生对不确定性的反应；TFA：模糊性容忍度
