Department of Psychiatry, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
Department of Psychiatry, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
BMJ Open. 2021 Nov 8;11(11):e054173. doi: 10.1136/bmjopen-2021-054173.
Psychiatric comorbidities are common in physical illness and significantly affect health outcomes. Attitudes of general hospital doctors toward psychiatry are important as they influence referral patterns and quality of care. Little is known about these attitudes and their cultural correlates. The aim of this study was to identify attitudes toward psychiatry among general hospital specialists in relation to culture of the practice setting and other clinician factors (gender, age, seniority and specialty).
A cross-sectional, descriptive study was carried out in seven countries (New Zealand, China, Sri Lanka, Russia, Israel, Brazil, the Netherlands). Data were collected from senior medical staff of various disciplines using an updated version of Mayou and Smith's (1986) self-administered questionnaire.
A total of 889 hospital doctors participated. While favourable attitudes toward both psychiatric consultation and management were endorsed by a majority, significant differences were also observed between countries. Subgroup differences were mostly confined to gender, acuity of practice setting and specialty. For example, female doctors in Russia (χ=7.7, p=0.0056), China (χ=9.2, p=0.0025) and the Netherlands (χ=5.7, p=0.0174) endorsed more positive attitudes compared with their male counterparts, but this gender effect was not replicated in the total sample. Chronic care specialists were overall more inclined to manage patients' emotional problems compared with those working in acute care (χ=70.8, p (adjusted)<0.0001), a significant finding seen also in individual countries (China, New Zealand, the Netherlands, Russia). Physicians were more favourably disposed toward psychiatry compared with other specialists, especially surgeons, in all countries except Israel.
This study adds to evidence for the association of medical attitudes with individual clinician factors and demonstrates that the influence of these factors varies by country. Understanding these issues may help to overcome barriers and improve quality of care provided to general hospital patients.
精神科合并症在躯体疾病中很常见，并且会显著影响健康结局。综合医院医生对精神病学的态度非常重要，因为这会影响转诊模式和医疗服务质量。关于这些态度及其文化相关性，我们知之甚少。本研究的目的是确定综合医院专家对精神病学的态度，以及这些态度与实践环境的文化和其他临床医生因素（性别、年龄、资历和专业）之间的关系。
在七个国家（新西兰、中国、斯里兰卡、俄罗斯、以色列、巴西和荷兰）进行了一项横断面、描述性研究。使用 Mayou 和 Smith（1986 年）的自我管理问卷的更新版本，从不同学科的高级医务人员那里收集数据。
共有 889 名医院医生参与了研究。虽然大多数人对精神病学咨询和管理持赞成态度，但各国之间也存在显著差异。亚组差异主要限于性别、实践环境的紧迫性和专业。例如，俄罗斯（χ=7.7，p=0.0056）、中国（χ=9.2，p=0.0025）和荷兰（χ=5.7，p=0.0174）的女性医生对精神病学的态度比男性医生更为积极，但这种性别效应在总样本中并未得到复制。与从事急性护理的医生相比，从事慢性护理的专家总体上更倾向于管理患者的情绪问题（χ=70.8，p（调整）<0.0001），这一显著发现也见于个别国家（中国、新西兰、荷兰和俄罗斯）。除了以色列之外，在所有国家中，医生对精神病学的态度都比对其他专科医生（尤其是外科医生）更为积极。
本研究进一步证明了医生的态度与个体医生因素之间的关联，并证明这些因素的影响因国家而异。了解这些问题可能有助于克服障碍，提高对综合医院患者的医疗服务质量。
