Unidad de Educación Médica, Escuela de Medicina, Universidad Framcisco de Vitoria, Madrid, Spain.
Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba University, Córdoba, Spain.
BMC Fam Pract. 2021 Oct 25;22(1):213. doi: 10.1186/s12875-021-01555-0.
Studies conducted to understand how family doctors develop resilience and deal with the challenges posed by work-related stress, usually have focused on identifying the elements that generate resilience from psychological perspectives and their impact on coping strategies. Few have explored the role that personal qualities and values that traditionally motivate family physicians can play as drivers of well-being and resilience.
To explore attributes that exemplary family physicians (EFP) consider important for their work and the elements that, for them, are source of gratification and resources in the face of the adversities they encounter in their practice.
This is an exploratory study carried out by online survey. Eighty six doctors regarded as exemplary by their colleagues answered 7 close and 4 open-ended questions that explored their job satisfaction, the elements of their work that reward them, the difficulties and problems they usually encounter, the resources they use to cope with those problems, and the personal qualities they consider central to their work. Four researchers conducted a thematic (deductive and inductive) analysis of the free text responses received. Based on the results obtained, and through an iterative discussion process, the researchers proposed an integrated set of qualities at the core of their professionalism.
88.4% (76) of the doctors said they were satisfied with their work. However, they face problems (202 comments), including demanding patients, insensitive managers with unshared interests/care goals, excessive paperwork, work overload, or time pressures. Sources of gratification point to personal identity; clinical, relational, and collaborative efficiency; a holistic and comprehensive practice (centred on individuals); and a continuous search for excellence (149) and the root of their resources (135). These elements, in turn, corresponded to the attributes considered essential for the practice of family medicine (131).
For EFPs, certain professional values give meaning to their clinical practice and are a source of well-being and resources. This central focus on professional values and qualities can help for better understand the burnout nature and expand the type of action that promotes resilience. Further studies using a less structured qualitative research will be needed to confirm/expand these results.
为了了解家庭医生如何培养韧性并应对与工作相关的压力带来的挑战，研究通常侧重于从心理学角度确定产生韧性的因素及其对应对策略的影响。很少有研究探讨传统上激励家庭医生的个人素质和价值观在幸福感和韧性方面所起的作用。
探讨模范家庭医生（EFP）认为对其工作重要的属性，以及他们在实践中遇到困难时感到满足和获得资源的因素。
这是一项通过在线调查进行的探索性研究。86 名被同事认为是模范的医生回答了 7 个封闭式和 4 个开放式问题，这些问题探讨了他们的工作满意度、工作中令他们满意的因素、他们通常遇到的困难和问题、他们用来应对这些问题的资源，以及他们认为对工作至关重要的个人素质。四位研究人员对收到的自由文本回复进行了主题（演绎和归纳）分析。根据所得结果，并通过迭代讨论过程，研究人员提出了一套核心专业素质。
88.4%（76 名）的医生表示对自己的工作满意。然而，他们面临着一些问题（202 条评论），包括要求苛刻的患者、与他们没有共同利益/关怀目标的不敏感的管理者、过多的文书工作、工作超负荷或时间压力。满足感的来源指向个人身份；临床、关系和协作效率；整体和全面的实践（以个人为中心）；以及对卓越的持续追求（149 次）和资源的根源（135 次）。这些因素反过来又与家庭医学实践的基本属性（131 个）相对应。
对于 EFPs 来说，某些专业价值观使他们的临床实践具有意义，是幸福感和资源的源泉。对专业价值观和素质的这种核心关注可以帮助更好地理解倦怠的本质，并扩大促进韧性的行动类型。需要使用更非结构化的定性研究来进一步研究以确认/扩展这些结果。
