Cheshire Anna, Ridge Damien, Hughes John, Peters David, Panagioti Maria, Simon Chantal, Lewith George
University of Westminster, Department of Psychology, London.
Royal London Hospital for Integrated Medicine UCLH NHS Trust, London.
Br J Gen Pract. 2017 Jun;67(659):e428-e436. doi: 10.3399/bjgp17X690893. Epub 2017 May 8.
'Neoliberal' work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs.
To explore GPs' experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change.
Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews.
Focus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis.
There were 22 GP participants recruited: focus groups ( = 15) and interviews ( = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for 'good' doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work-life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced.
GPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues.
“新自由主义”工作政策、财政紧缩、国民医疗服务体系(NHS)重组以及全科医生(GP)诊疗率上升,构成了全科医生职业倦怠报告不断增加以及全科医生即将短缺这一现象的背景。
探讨全科医生在工作场所面临的挑战和压力的经历,以及他们的应对策略,尤其着重于理解近期国民医疗服务体系工作场所变化的影响。
研究设计为定性研究,数据收集自两个焦点小组和七次一对一电话访谈。
焦点小组和一对一电话访谈探讨了目前在英格兰执业的全科医生的经历,通过便利抽样招募。数据采用半结构化访谈方法收集,并使用主题分析法进行分析。
共招募了22名全科医生参与者:焦点小组(15名)和访谈(7名)。受访者认为全科医生承受着巨大且前所未有的压力,这些压力与他们的工作环境相关,对“良好”行医具有重要的道德影响。许多人报告称,全职担任全科医生压力过大:工作相关压力导致情绪变化、睡眠中断、焦虑增加以及与亲人关系紧张。一些人随后寻求减少临床工作量的方法。工作场所的变化使得有助于全科医生恢复适应力的事情几乎没有时间去做:良好的工作与生活平衡以及与同事更好的交流。尽管一些全科医生比其他人应对得更好,但全科医生承认,鉴于他们面临的外部工作问题,个体全科医生在管理压力方面能做的非常有限。
全科医生认为他们的情感生活和压力受到国民医疗服务体系因素的显著影响。为支持全科医生提供有效的医疗服务,恢复适应力的培养应超越个体层面,纳入系统性的工作问题。