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外科医生避免与患者心理社会因素的态度和信念相关的不适感的倾向是怎样的?

Are Surgeons' Tendencies to Avoid Discomfort Associated with Attitudes and Beliefs Toward Patient Psychosocial Factors?

作者信息

Bakhshaie Jafar, Doorley James, Reichman Mira, Crijns Tom J, Archer Kristin R, Wegener Stephen T, Castillo Renan C, Ring David, Vranceanu Ana-Maria

机构信息

Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.

Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA.

出版信息

Arch Bone Jt Surg. 2022 Jul;10(7):611-620. doi: 10.22038/ABJS.2022.55134.2745.

Abstract

BACKGROUND

Orthopedic surgeons are sometimes hesitant to assess and address psychosocial factors. Surgeon-specific modifiable factors may contribute to surgeon attitudes and beliefs regarding the mental and social aspects of illness. A better understanding of these factors could help inform interventions to support surgeons and improve patient outcomes. We aimed to investigate whether orthopedic surgeons' self-reported compassion, perceived stress, and experiential avoidance are independently associated with various surgeon attitudes and beliefs regarding psychosocial aspects of health.

METHODS

This is a cross-sectional study of 165 members of the Science of Variation Group (SOVG). Surgeons completed measures of compassion, stress, experiential avoidance, and demographics. They answered questions addressing attitudes and beliefs regarding psychosocial aspects of care, which were condensed to the following 6 dimensions through factor analysis: (1) confidence, (2) perceived resource availability, (3) blame towards patients, (4) fear of offending patients, (5) professional role resistance, and (6) fear of negative patient reactions. We performed 6 multivariable hierarchical regression analyses to determine whether self-reported compassion, perceived stress, and experiential avoidance were associated with aspects of surgeons' attitudes and beliefs regarding psychosocial care.

RESULTS

After accounting for the influence of relevant covariates, experiential avoidance explained 2.9-6.6% of the variance ( .002 to .031) in all aspects of surgeon attitudes and beliefs regarding psychosocial care, except for perceived resource availability. Perceived stress and compassion toward others were not associated with any outcome variable.

CONCLUSION

Targeting orthopedic surgeons' tendency to avoid discomfort (i.e., experiential avoidance) via supportive/educational programs may decrease barriers and increase their abilities to address psychosocial factors, resulting in improved patient outcomes.

摘要

背景

骨科医生有时不愿评估和处理心理社会因素。特定于外科医生的可改变因素可能导致外科医生对疾病的心理和社会方面的态度和信念。更好地理解这些因素有助于为支持外科医生并改善患者结局的干预措施提供信息。我们旨在调查骨科医生自我报告的同情心、感知压力和经验性回避是否与外科医生对健康心理社会方面的各种态度和信念独立相关。

方法

这是一项对165名变异科学小组(SOVG)成员的横断面研究。外科医生完成了同情心、压力、经验性回避和人口统计学测量。他们回答了关于护理心理社会方面的态度和信念的问题,通过因子分析将这些问题浓缩为以下6个维度:(1)信心,(2)感知资源可用性,(3)对患者的指责,(4)害怕冒犯患者,(5)职业角色抵触,(6)害怕患者的负面反应。我们进行了6次多变量分层回归分析,以确定自我报告的同情心、感知压力和经验性回避是否与外科医生对心理社会护理的态度和信念方面相关。

结果

在考虑相关协变量的影响后,经验性回避解释了外科医生对心理社会护理的态度和信念所有方面(除感知资源可用性外)2.9%至6.6%的方差(P值为0.002至0.031)。感知压力和对他人的同情心与任何结果变量均无关联。

结论

通过支持性/教育项目针对骨科医生避免不适的倾向(即经验性回避),可能会减少障碍并提高他们处理心理社会因素的能力,从而改善患者结局。

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