Avery Jonathan D, Taylor Katherine E, Kast Kristopher A, Kattan Jessica, Gordon-Elliot Janna, Mauer Elizabeth, Avery Joseph J, Penzner Julie B
Department of Psychiatry, Weill Cornell Medical College, 525 East 68th St, Box 140, New York, NY 10065.
Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA.
Prim Care Companion CNS Disord. 2019 Jan 3;21(1):18m02382. doi: 10.4088/PCC.18m02382.
Resident physicians frequently provide care for individuals diagnosed with mental illness and substance use disorders (SUDs). Clinicians-including psychiatrists and addiction professionals-have been shown to possess negative attitudes toward these individuals, which is concerning since negative attitudes may have an adverse impact on patient engagement, treatment, and outcomes. However, little is known about resident physicians' attitudes toward individuals with mental illness and SUDs. The objective of this study was to examine the attitudes of emergency medicine, internal medicine, and obstetrics-gynecology residents toward individuals with diagnoses of schizophrenia, multiple SUDs, co-occurring schizophrenia and SUDs, and major depressive disorder.
A web-based questionnaire, including demographic information, level of training, and the 11-item Medical Condition Regard Scale (MCRS) for individuals with 4 different diagnoses, which assesses the degree to which clinicians find individuals with a given medical condition to be enjoyable, treatable, and worthy of medical resources, was sent to residents across the United States from May 2016 to April 2017.
A total of 411 resident physicians completed the questionnaire. Respondents had more negative attitudes toward individuals with diagnoses of SUDs with and without schizophrenia than toward those individuals with diagnoses of schizophrenia or major depressive disorder alone. Senior residents possessed more negative attitudes toward individuals with SUDs than did junior residents. Emergency medicine residents had more negative attitudes than the other resident physician groups.
The attitudes of resident physicians toward individuals with SUDs with and without schizophrenia were negative and were worse among emergency medicine residents and senior residents. Additional research and programmatic work are needed to understand the reasons for these negative attitudes and to develop interventions during residency training to improve them.
住院医师经常为被诊断患有精神疾病和物质使用障碍(SUDs)的个体提供护理。包括精神科医生和成瘾专业人员在内的临床医生已被证明对这些个体持有消极态度,这令人担忧,因为消极态度可能会对患者的参与度、治疗及治疗结果产生不利影响。然而,对于住院医师对患有精神疾病和SUDs的个体的态度却知之甚少。本研究的目的是调查急诊医学、内科和妇产科住院医师对被诊断患有精神分裂症、多种SUDs、精神分裂症和SUDs并发以及重度抑郁症的个体的态度。
2016年5月至2017年4月,向美国各地的住院医师发送了一份基于网络的问卷,其中包括人口统计学信息、培训水平以及针对4种不同诊断个体的11项医疗状况关注量表(MCRS),该量表评估临床医生认为患有特定医疗状况的个体在多大程度上令人愉悦、可治疗且值得获得医疗资源。
共有411名住院医师完成了问卷。与仅被诊断患有精神分裂症或重度抑郁症的个体相比,受访者对被诊断患有SUDs(无论是否伴有精神分裂症)的个体持有更消极的态度。高年资住院医师对患有SUDs的个体的态度比低年资住院医师更消极。急诊医学住院医师的态度比其他住院医师群体更消极。
住院医师对患有SUDs(无论是否伴有精神分裂症)的个体持有消极态度,且在急诊医学住院医师和高年资住院医师中更为严重。需要开展更多研究和规划工作,以了解这些消极态度产生的原因,并在住院医师培训期间制定干预措施以改善这些态度。