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家庭医生预防角色态度的结构方程模型:瑞士的一项横断面研究。

A structural equation model of the family physicians attitude towards their role in prevention: a cross-sectional study in Switzerland.

机构信息

Institute of Family Medicine, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.

Institute for Work and Health, Lausanne University and Geneva University, Lausanne, Switzerland.

出版信息

Fam Pract. 2019 May 23;36(3):297-303. doi: 10.1093/fampra/cmy063.

Abstract

BACKGROUND

In contrast to many studies exploring barriers to preventive care in family medicine, there is less quantitative research regarding the self-perceived role of family physicians (FPs) in prevention and its predictive factors. Moreover, the existing studies considered this attitude as a homogeneous entity. The objective of this study is firstly, to characterize FPs' attitudes towards prevention taking into account nine different prevention themes, and secondly, to explore the factors that could be predictive of this attitude.

METHODS

The data stem from a cross-sectional national survey on prevention we conducted in Switzerland from 2015 to 2016 (170 physicians randomly drawn, online questionnaire). We first performed a confirmatory factor analysis to define a homogeneous latent variable regarding physicians' attitude towards prevention, then, a structural equation modeling to identify potential predictors.

RESULTS

The FP' attitude towards their role in preventive care was homogeneously positive whatever the topic (smoking, drinking dietary habits, physical activities, and more generally, cardiovascular risk factors) except for occupational risks and cannabis consumption. A feeling of good effectiveness was a positive predictor of this positive attitude while seniority, the lack of reimbursement and being a physician from the German-speaking area were negative predictors.

CONCLUSION

The FP' attitude about their role in prevention is homogeneous concerning the 'classical' topics of prevention, whereas they still under-recognize certain topics as important fields for prevention. To change this situation, we probably need a global effort to introduce other ways of thinking about prevention, including not only FP but also all stakeholders.

摘要

背景

与许多探索家庭医学中预防保健障碍的研究相比,关于家庭医生(FP)对预防的自我感知角色及其预测因素的定量研究较少。此外,现有研究将这种态度视为同质实体。本研究的目的首先是描述 FP 对预防的态度,考虑到九个不同的预防主题,其次是探讨可能预测这种态度的因素。

方法

数据来自我们于 2015 年至 2016 年在瑞士进行的一项关于预防的横断面全国调查(随机抽取的 170 名医生,在线问卷)。我们首先进行验证性因子分析,以确定医生对预防的态度的同质潜在变量,然后进行结构方程建模以确定潜在的预测因素。

结果

FP 对其在预防保健中角色的态度无论主题如何(吸烟、饮酒、饮食习惯、体育活动以及更一般的心血管危险因素)都是同质积极的,除了职业风险和大麻消费。对良好效果的感觉是这种积极态度的积极预测因素,而资历、缺乏报销和来自德语区的医生则是消极预测因素。

结论

FP 对其在预防中的角色的态度在“经典”预防主题方面是同质的,而他们仍然没有认识到某些主题是预防的重要领域。为了改变这种情况,我们可能需要共同努力,引入其他关于预防的思维方式,包括不仅仅是 FP,还有所有利益相关者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d6e/6531892/a7edb85655f7/cmy06301.jpg

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