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初级保健中同理心、职业倦怠与药物处方质量之间关联的横断面研究。

Cross-sectional study of the association between empathy and burnout and drug prescribing quality in primary care.

作者信息

Yuguero O, Marsal J R, Esquerda M, Galvan L, Soler-González J

机构信息

Transversal Emergency Research Group, Biomedical Research Institute of Lleida (IRBLLEIDA), Lleida, Spain.

Surgery DepartmentFaculty of Medicine, University of Lleida, Lleida, Spain.

出版信息

Prim Health Care Res Dev. 2019 Oct 30;20:e145. doi: 10.1017/S1463423619000793.

Abstract

OBJECTIVE

The aim of this study was to assess whether burnout and empathy levels among general practitioners (GPs) might influence prescribing performance assessed using pharmaceutical prescription quality standard indicators.

DESIGN AND SETTING

Cross-sectional descriptive study of 108 GPs from 22 primary care centers in Lleida, Spain, and of centralized data corresponding to 183 600 patients under their care. The study was conducted between May and July 2014.

MAIN OUTCOME MEASURES

Burnout and empathy were measured using the Spanish versions of the Maslach Burnout Inventory and the Jefferson Scale for Physician Empathy, and prescribing quality was measured using the Catalan Pharmaceutical Prescription Quality Standard (EQPF). Normal distribution of scores was verified using the Chi-square and Kolmogorov-Smirnov-Lilliefors tests. The effect of each of the variables was evaluated using crude odds ratios.

RESULTS

Older GPs scored significantly higher in the EQPF (P < 0.05). High empathy scores were positively associated with high EQPF scores. GPs with low burnout also performed better in the EQPF.

CONCLUSIONS

More empathic, less burned-out, older GPs showed better prescribing performance according to quality indicators. However, further studies are needed to evaluate other factors influencing prescribing habits. The promotion of communication skills may increase empathy and reduce burnout, thus benefiting patients.

摘要

目的

本研究旨在评估全科医生(GP)的职业倦怠和共情水平是否会影响使用药品处方质量标准指标评估的处方行为。

设计与背景

对来自西班牙莱里达22个初级保健中心的108名全科医生以及与其所照料的183600名患者相关的集中数据进行横断面描述性研究。研究于2014年5月至7月进行。

主要观察指标

使用西班牙文版的马氏职业倦怠量表和杰斐逊医生共情量表测量职业倦怠和共情水平,使用加泰罗尼亚药品处方质量标准(EQPF)测量处方质量。使用卡方检验和柯尔莫哥洛夫-斯米尔诺夫-利列福斯检验验证分数的正态分布。使用粗比值比评估每个变量的影响。

结果

年长的全科医生在EQPF中的得分显著更高(P < 0.05)。高共情得分与高EQPF得分呈正相关。职业倦怠程度低的全科医生在EQPF中的表现也更好。

结论

根据质量指标,更具共情、职业倦怠程度更低、年龄更大的全科医生表现出更好的处方行为。然而,需要进一步研究以评估影响处方习惯的其他因素。提升沟通技巧可能会增强共情并减少职业倦怠,从而使患者受益。

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