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了解患者如何看待医生的健康状况及其与患者护理的关系:一项定性研究。

Understanding how patients perceive physician wellness and its links to patient care: A qualitative study.

机构信息

Cumming School of Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada.

W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.

出版信息

PLoS One. 2018 May 15;13(5):e0196888. doi: 10.1371/journal.pone.0196888. eCollection 2018.

Abstract

Despite increased interest in physician wellness, little is known about patients' views on the topic. We explore patients' perceptions of physician wellness and how it links to patient care. This exploratory, qualitative study employed semi-structured interviews with a convenience sample of 20 patients from outpatient care settings in a western Canadian city. Using inductive thematic analysis, interview transcripts were independently coded by two authors and then discussed to ensure consensus and to abstract into higher-level themes. Three overarching premises were identified. First, patients notice cues that they interpret as signs of physician wellness. These include overt indicators, such as a physician's demeanor or physical appearance, along with a general impression about a physician's wellness. Second, patients form judgments based on what they notice, and these judgments affect patients' views about their care; feelings, such as trust, in their interactions with physicians; and actions, such as following care plans. Third, participants perceive a bi-directional link between physician wellness and patient care. Physician wellness impacts patient care, but physician wellness is also impacted by the care they provide and the challenges they face within the healthcare system. Patients' judgments regarding physician wellness may have important impacts on the doctor-patient relationship. Furthermore, patients appear to have a nuanced understanding about how physicians' work may put physicians at risk for being unwell. Patients may be powerful allies in supporting physician wellness initiatives focused on the shared responsibility of individual physicians, the medical profession, and healthcare organizations.

摘要

尽管人们对医生的健康越来越感兴趣,但对于患者对该主题的看法却知之甚少。我们探讨了患者对医生健康的看法,以及它与患者护理的关系。这项探索性的定性研究采用方便抽样法,对加拿大西部城市门诊环境中的 20 名患者进行了半结构化访谈。使用归纳主题分析,两位作者独立对访谈记录进行编码,然后进行讨论以确保达成共识并将其抽象为更高层次的主题。确定了三个总体前提。首先,患者会注意到他们认为是医生健康状况的迹象的线索。这些线索包括明显的指标,如医生的举止或外表,以及对医生健康状况的总体印象。其次,患者根据他们所注意到的情况做出判断,这些判断会影响他们对护理的看法;他们与医生互动时的感受,如信任;以及他们是否遵循护理计划等行为。第三,参与者认为医生的健康和患者护理之间存在双向联系。医生的健康状况会影响患者的护理,但医生的健康状况也会受到他们所提供的护理和他们在医疗保健系统中面临的挑战的影响。患者对医生健康状况的判断可能对医患关系产生重要影响。此外,患者似乎对医生的工作如何使他们面临不健康的风险有了细致的理解。患者可能是支持以个体医生、医疗行业和医疗机构的共同责任为重点的医生健康倡议的有力盟友。

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