Department of Family Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
BMC Health Serv Res. 2023 Oct 16;23(1):1101. doi: 10.1186/s12913-023-10057-x.
Physicians appear to vary in their motivation towards using virtual care, but to what extent is unclear. To better understand this variance, which is important for supporting physician wellbeing and therefore patient care, the authors used self-determination theory's (SDT) framework. According to SDT, different types of motivation exist, ranging from controlled to autonomous, that lend to differences in engagement, performance, and wellbeing. The authors aimed to determine: (a) if there were distinct groups of physicians based on their quality of motivation towards using virtual care, and if so, (b) how these groups varied in fulfillment of basic psychological needs (autonomy, competence, and relatedness) in the workplace.
In March-August 2022, the authors collected quantitative, survey-based data from a cross-section of 156 family physicians in Alberta, Canada. The survey contained existing scales that measure types of motivation (autonomous vs. controlled) and basic psychological need satisfaction/frustration at work. Cluster analysis was used to explore profiles of physician motivation towards using virtual care, and analysis of variance was used to determine how each profile differed with respect to workplace need fulfillment.
With motivation towards using virtual care, three higher-order profiles of physician motivation were identified: autonomous (19% family physicians), controlled (16% of family physicians), and ambivalent (66% of family physicians). The three profiles differed significantly in terms of psychological need fulfillment at work.
This study identifies specific profiles that family physicians currently fall into when it comes to motivation towards using virtual care. In line with SDT, findings suggest that basic psychological needs are fundamental nutrients for physicians to internalize and endorse the value of using virtual care in their practices. Implications for physician wellbeing are discussed.
医生在使用虚拟医疗服务的动机方面似乎存在差异,但具体程度尚不清楚。为了更好地理解这种差异,这对于支持医生的幸福感从而改善患者护理非常重要,作者使用了自我决定理论(SDT)的框架。根据 SDT,存在不同类型的动机,从控制到自主,这导致了参与度、绩效和幸福感的差异。作者旨在确定:(a)是否存在基于使用虚拟医疗服务的动机质量的不同医生群体,如果存在,(b)这些群体在工作场所的基本心理需求(自主性、能力和关联性)满足方面有何不同。
在 2022 年 3 月至 8 月期间,作者从加拿大阿尔伯塔省的 156 名家庭医生中收集了基于调查的定量数据。该调查包含了衡量动机类型(自主与控制)和工作场所基本心理需求满足/受挫的现有量表。聚类分析用于探索医生使用虚拟医疗服务的动机模式,方差分析用于确定每个模式在工作场所需求满足方面的差异。
使用虚拟医疗服务的动机方面,确定了医生动机的三个高级别模式:自主(19%的家庭医生)、控制(16%的家庭医生)和矛盾(66%的家庭医生)。这三个模式在工作中的心理需求满足方面存在显著差异。
本研究确定了家庭医生在使用虚拟医疗服务的动机方面当前所处的具体模式。与 SDT 一致,研究结果表明,基本心理需求是医生内化和认可在实践中使用虚拟医疗服务价值的基本营养物质。讨论了对医生幸福感的影响。