Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Nijmegen, the Netherlands.
PLoS One. 2020 Apr 3;15(4):e0231084. doi: 10.1371/journal.pone.0231084. eCollection 2020.
Substance use disorders (SUD) in physicians often remain concealed for a long time. Peer monitoring and open discussions with colleagues are essential for identifying SUD. However, physicians often feel uncomfortable discussing substance use with a colleague. We explored physicians' attitudes and norms about substance use (disorders) and their (intended) approach upon a presumption of substance use in a colleague.
An online cross-sectional survey concerning "Addiction in physicians" was administered by the Royal Dutch Medical Association physician panel. Overall, 1685 physicians (47%) responded. Data were analyzed by logistic regression to explore factors associated with taking action upon a substance use presumption.
Most physicians agreed that SUD can happen to anyone (67%), is not a sign of weakness (78%) and that it is a disease that can be treated (83%). Substance use in a working context was perceived as unacceptable (alcohol at work: 99%, alcohol during a standby duty: 91%, alcohol in the eight hours before work: 77%, and illicit drugs in the eight hours before work: 97%). Almost all respondents (97%) intend to act upon a substance use presumption in a colleague. Of the 29% who ever had this presumption, 65% took actual action. Actual action was associated with male gender and older age (OR = 1.81; 95% CI = 1.20-2.74 and OR = 1.03; 95% CI = 1.01-1.05, respectively).
About one-third of physicians reported experience with a presumption of substance use in a colleague. Whilst most physicians intend to take action upon such a presumption, two-thirds actually do act upon a presumption. To bridge this intention-behavior gap continued medical education on signs and symptoms of SUD and instructions on how to enter a supportive dialogue with a colleague about personal issues, may enhance physicians' knowledge, confidence, and ethical responsibility to act upon a presumption of substance use or other concerns in a colleague.
医生的物质使用障碍（SUD）通常会长期隐瞒。同行监督和与同事公开讨论对于识别 SUD 至关重要。然而，医生通常对与同事讨论物质使用问题感到不舒服。我们探讨了医生对物质使用（障碍）的态度和规范，以及他们在假定同事存在物质使用问题时的（预期）方法。
荷兰皇家医师协会的医师小组通过在线横断面调查，对“医生中的成瘾问题”进行了调查。共有 1685 名医生（47%）做出了回应。通过逻辑回归分析数据，以探讨在假定物质使用问题的情况下采取行动的相关因素。
大多数医生认为 SUD 可能发生在任何人身上（67%），不是弱点的标志（78%），并且可以治疗（83%）。在工作环境中的物质使用被认为是不可接受的（工作时饮酒：99%，待命时饮酒：91%，工作前八小时内饮酒：77%，工作前八小时内使用非法药物：97%）。几乎所有的受访者（97%）都打算对同事的物质使用问题采取行动。在曾有过这种假定的 29%的人中，有 65%采取了实际行动。实际行动与男性性别和年龄较大有关（OR=1.81；95%CI=1.20-2.74 和 OR=1.03；95%CI=1.01-1.05）。
约三分之一的医生报告称在同事中曾有过物质使用问题的假定。尽管大多数医生打算在这种假定下采取行动，但实际上有三分之二的人会采取行动。为了弥合这种意图与行为之间的差距，继续教育医生识别 SUD 的症状和体征，并指导他们如何与同事进行支持性对话，以解决个人问题，这可能会提高医生对同事物质使用或其他问题的察觉能力、信心和道德责任感，从而促使他们采取行动。
