探讨手术实践中的变异性：外科医生的个性是否影响吻合决策？
Exploring variation in surgical practice: does surgeon personality influence anastomotic decision-making?
机构信息
Department of General Surgery, Royal Alexandra Hospital, Paisley, UK.
Department of Medical Education, University of Aberdeen, Aberdeen, UK.
出版信息
Br J Surg. 2022 Oct 14;109(11):1156-1163. doi: 10.1093/bjs/znac200.
BACKGROUND
Decision-making under uncertainty may be influenced by an individual's personality. The primary aim was to explore associations between surgeon personality traits and colorectal anastomotic decision-making.
METHODS
Colorectal surgeons worldwide participated in a two-part online survey. Part 1 evaluated surgeon characteristics using the Big Five Inventory to measure personality (five domains: agreeableness; conscientiousness; extraversion; emotional stability; openness) in response to scenarios presented in Part 2 involving anastomotic decisions (i.e. rejoining the bowel with/without temporary stomas, or permanent diversion with end colostomy). Anastomotic decisions were compared using repeated-measure ANOVA. Mean scores of traits domains were compared with normative data using two-tailed t tests.
RESULTS
In total, 186 surgeons participated, with 127 surgeons completing both parts of the survey (68.3 per cent). One hundred and thirty-one surgeons were male (70.4 per cent) and 144 were based in Europe (77.4 per cent). Forty-one per cent (77 surgeons) had begun independent practice within the last 5 years. Surgeon personality differed from the general population, with statistically significantly higher levels of emotional stability (3.25 versus 2.97 respectively), lower levels of agreeableness (3.03 versus 3.74), extraversion (2.81 versus 3.38) and openness (3.19 versus 3.67), and similar levels of conscientiousness (3.42 versus 3.40 (all P <0.001)). Female surgeons had significantly lower levels of openness (P <0.001) than males (3.06 versus 3.25). Personality was associated with anastomotic decision-making in specific scenarios.
CONCLUSION
Colorectal surgeons have different personality traits from the general population. Certain traits seem to be associated with anastomotic decision-making but only in specific scenarios. Further exploration of the association of personality, risk-taking, and decision-making in surgery is necessary.
背景
在不确定的情况下做出决策可能会受到个体性格的影响。主要目的是探讨外科医生个性特征与结直肠吻合决策之间的关系。
方法
来自世界各地的结直肠外科医生参与了一项两部分的在线调查。第一部分使用大五人格量表评估了外科医生的特征，以测量个性（五个维度：宜人性；尽责性；外向性；情绪稳定性；开放性），并对第二部分中涉及吻合决策的场景做出反应（即是否重新连接肠道，是否有临时造口，或永久性分流，行末端结肠造口术）。使用重复测量方差分析比较吻合决策。使用双侧 t 检验将特质域的平均分数与规范数据进行比较。
结果
共有 186 名外科医生参与了研究，其中 127 名外科医生完成了调查的两部分（68.3%）。131 名外科医生为男性（70.4%），144 名外科医生来自欧洲（77.4%）。41%（77 名）的外科医生在过去 5 年内开始独立执业。外科医生的个性与普通人群不同，情绪稳定性显著更高（分别为 3.25 和 2.97），宜人性显著更低（分别为 3.03 和 3.74），外向性显著更低（分别为 2.81 和 3.38），开放性显著更低（分别为 3.19 和 3.67），尽责性相似（分别为 3.42 和 3.40，均 P <0.001）。女性外科医生的开放性明显低于男性（P <0.001）（分别为 3.06 和 3.25）。个性与特定场景下的吻合决策有关。
结论
结直肠外科医生的个性特征与普通人群不同。某些特质似乎与吻合决策有关，但仅在特定情况下有关。进一步探讨个性、冒险行为和手术决策之间的关系是必要的。
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