定位工作相关压力——全科医生使用 WSQ 并结合咨询时的反馈进行推理的情况。

Positioning work related stress - GPs' reasoning about using the WSQ combined with feedback at consultation.

机构信息

Unit of Occupational Therapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

出版信息

BMC Fam Pract. 2020 Sep 11;21(1):187. doi: 10.1186/s12875-020-01258-y.

DOI:10.1186/s12875-020-01258-y

PMID:32917138

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7488670/

Abstract

BACKGROUND

General practitioners (GPs) regularly handle cases related to stress and work capacity, but often find this work difficult. However, using an assessment tool in a structured way can increase GPs' awareness of the risk for sick leave and need of referrals to preventive measures. Today there is no established methodical practice for this in primary health care. The aim of this study was to explore GPs' reasoning about using the Work Stress Questionnaire combined with feedback at consultation as an early intervention to reduce sick leave.

METHODS

A focus group study was performed with 23 GPs at six primary health care centres. The discussions were analysed based on a method by Krueger.

RESULTS

Three themes emerged. Positioning work-related stress describes the need to make fundamental standpoints on stress and how it should be handled, to make sense of their work concerning work-related stress. Making use of resources focuses on GPs performing to the best of their ability using assigned resources to treat patients with stress-related ill health, even if the resources were perceived as insufficient. Practising daily work focuses on the GPs' regular and preferred way of working set against the degree of intrusion and benefits. The two related themes making use of resources and practising daily work were mirrored through the third theme, positioning work-related stress, to form an understanding of how GPs should work with patients perceiving work-related stress.

CONCLUSIONS

The GPs own competence and tools, those of other professionals and the time allocated were seen as important when treating patients perceiving ill health due to work-related stress. When resources were insufficient though, the GPs questioned their responsibility for these patients. The results also indicate that the GPs viewed their ordinary consultative way of working as sufficient to identify these patients. The intervention was therefore not seen as useful for early treatment of patients at risk of sick leave due to work-related stress. However, prevention is an important part of the PHC's responsibility, and strategies concerning stress-related ill health therefore need to be more thoroughly formulated and incorporated.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02480855 . Registered 20 May 2015.

摘要

背景

全科医生（GP）经常处理与压力和工作能力相关的案例，但他们常发现这项工作颇具难度。然而，通过结构化的方式使用评估工具可以提高全科医生对请病假风险和需要转诊至预防措施的认识。目前，初级保健中尚无既定的方法学实践。本研究的目的是探讨全科医生使用工作压力问卷并结合咨询中的反馈作为减少病假的早期干预措施的推理。

方法

在六家初级保健中心进行了一项焦点小组研究，共有 23 名全科医生参加。讨论分析基于 Krueger 的方法进行。

结果

出现了三个主题。定位与工作相关的压力描述了在压力方面和如何处理压力方面做出基本立场的必要性，以便理解他们与工作相关压力相关的工作。利用资源侧重于全科医生充分利用分配的资源来治疗因工作相关健康问题而患病的患者，即使资源被认为不足。实践日常工作侧重于全科医生的日常工作方式，以及侵入程度和收益。与利用资源和实践日常工作这两个相关主题通过第三个主题，即定位与工作相关的压力，形成了全科医生应该如何与感知与工作相关的压力的患者合作的理解。

结论

在治疗因工作相关压力而感到不适的患者时，全科医生自身的能力和工具、其他专业人员的能力和时间分配被认为是重要的。然而，当资源不足时，全科医生会质疑他们对这些患者的责任。结果还表明，全科医生认为他们普通的咨询工作方式足以识别这些患者。因此，该干预措施并未被视为治疗因工作相关压力而有请假风险的患者的早期治疗的有效方法。然而，预防是初级保健的重要责任，因此需要更全面地制定和实施与工作相关的健康问题相关的策略。