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中国医生自我认知的职业声誉受损状况、原因及后果:一项横断面调查

Status, causes and consequences of physicians' self-perceived professional reputation damage in China: a cross-sectional survey.

作者信息

Sun Tao, Wang Jinghui, Zhang Shu'e, Shi Yu, Liu Bei, Wang Xiaohe

机构信息

Department of Health Management to School of Medicine, Hang Zhou Normal University, No.2318 Yuhangtang Road, Cangqian Street, Yuhang District, Hangzhou City, 311121, Zhejiang Province, China.

College of Health Management of Harbin Medical University, Harbin, 150086, China.

出版信息

BMC Health Serv Res. 2021 Apr 14;21(1):344. doi: 10.1186/s12913-021-06306-6.

Abstract

BACKGROUND

Conflict between physicians and patients is an increasingly serious problem, leading to the disrepute attached to Chinese physicians' social image and position. This study assesses the status of physicians' self-perceived professional reputation damage and explains it's the adverse outcomes including withdrawal behavior and workplace well-being. Moreover, potential causes of Chinese physicians' disrepute have been outlined.

METHODS

Primary data were collected through a cross-sectional online survey of physicians from 10 provinces in China, who were invited to complete an anonymous survey from December 2018 to January 2019. A total of 842 physicians (effective response rate: 92.22%) were recruited as participants.

RESULTS

About 83% of the participants self-perceived professional reputation damage from the sense of the public opinion concept. Approach half of participants exhibited the idea of turnover intention (47.3%) and one or more symptoms of burnout (46.4%). About 74.9% of the participants experienced a degree of stress. Additionally, three out of five participants reported low-level subjective well-being. More than 70% of the participants disapproved of their offspring becoming a physician. Four factors leading to physicians' damaged professional reputations are those addressed: conflict transfer, cognitive bias, improper management, and individual deviance. Stigmatised physicians are more likely to practice high-frequent defensive medicine (β = 0.172, P <0.001), intend to leave the profession (β = 0.240, P <0.001), disapprove of their children becoming physicians (β = 0.332, P<0.001) and yield worse levels of workplace well-being, including high levels of perceived stress (β = 0.214, P <0.001), increasing burnout (β = 0.209, P <0.001), and declining sense of well-being (β = - 0.311, P<0.001).

CONCLUSION

Chinese physicians were aware of damaged professional reputations from the sense of the public opinion concept, which contributes to increasing withdrawal behaviors and decreasing workplace well-being-a worsening trend threatening the entire health system. This novel evidence argues a proposal that Chinese health policy-makers and hospital administrators should promote the destigmatization of physicians immediately.

摘要

背景

医患冲突是一个日益严重的问题,导致中国医生的社会形象和地位受损。本研究评估了医生自我感知的职业声誉受损状况,并解释了其不良后果,包括退缩行为和工作场所幸福感。此外,还概述了中国医生声誉受损的潜在原因。

方法

通过对中国10个省份的医生进行横断面在线调查收集原始数据,邀请他们在2018年12月至2019年1月期间完成一项匿名调查。共招募了842名医生作为参与者(有效回复率:92.22%)。

结果

约83%的参与者从舆论观念中自我感知到职业声誉受损。近一半的参与者表现出离职意向(47.3%)和一种或多种职业倦怠症状(46.4%)。约74.9%的参与者经历了一定程度的压力。此外,五分之三的参与者报告主观幸福感较低。超过70%的参与者不赞成自己的后代成为医生。导致医生职业声誉受损的四个因素包括:冲突转移、认知偏差、管理不当和个人越轨。声誉受损的医生更有可能频繁采取防御性医疗行为(β = 0.172,P <0.001),打算离开该职业(β = 0.240,P <0.001),不赞成自己的孩子成为医生(β = 0.332,P <0.001),并且工作场所幸福感较差,包括高水平的感知压力(β = 0.214,P <0.001)、职业倦怠加剧(β = 0.209,P <0.001)和幸福感下降(β = -0.311,P <0.001)。

结论

中国医生从舆论观念中意识到职业声誉受损,这导致退缩行为增加和工作场所幸福感下降,这种恶化趋势威胁着整个卫生系统。这一新证据表明,中国卫生政策制定者和医院管理人员应立即推动消除对医生的污名化。

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