Williams Betsy W, Welindt Dillon
Clinical Program Director, Professional Renewal Center®, Lawrence, KS, USA.
Director of Education, Wales Behavioral Assessment, Lawrence, KS, USA; Clinical Associate Professor, Department of Psychiatry, School of Medicine, University of Kansas, Lawrence, KS, USA.
Australas Psychiatry. 2023 Apr;31(2):132-135. doi: 10.1177/10398562231156477. Epub 2023 Feb 7.
The aim of this article is to discuss the etiology, prevalence, impact, and management of disruptive behavior in physicians. These various aspects will be examined at both the individual and system level, to provide appropriate perspective and detail effective approaches to address these behaviors.
Clinical experience and review of the authors' and other researchers' findings provide consensus on numerous key aspects of physician disruptive behavior.
Physicians demonstrating disruptive behavior are often distressed. The behavior should be understood as arising from biopsychosocial contributors, knowledge gaps, insight, and systems factors. These contributors are inclusive and may interact with each other.
A comprehensive approach is required which can include assessment/reassessment tools, individualized programming (therapy, coaching, instruction), deliberate practice, medical follow-up, and system intervention. Complications include the diversity of disruptive behaviors, the many contributory factors therein, disagreement about methodology/measurement, and the role of the system.
本文旨在探讨医生破坏性行为的病因、患病率、影响及管理。将在个体和系统层面审视这些不同方面，以提供恰当视角并详述应对这些行为的有效方法。
作者的临床经验以及对作者和其他研究者研究结果的回顾，在医生破坏性行为的众多关键方面达成了共识。
表现出破坏性行为的医生通常处于苦恼状态。应将这种行为理解为由生物心理社会因素、知识差距、洞察力及系统因素引发。这些因素相互包容且可能相互作用。
需要一种综合方法，可包括评估/重新评估工具、个性化方案（治疗、辅导、指导）、刻意练习、医学随访及系统干预。并发症包括破坏性行为的多样性、其中众多的促成因素、在方法/测量上的分歧以及系统的作用。
