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参与老年医疗保健的日本医生的特征与他们治疗多病共存老年患者的方法之间的关系。

Relationship between the characteristics of Japanese physicians involved in medical care for older adults and their approaches to treating older patients with multimorbidity.

机构信息

Department of R&D Innovation for Home Care Medicine, Department of General Medicine, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan.

Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Akita, Japan.

出版信息

PLoS One. 2024 Jun 12;19(6):e0302532. doi: 10.1371/journal.pone.0302532. eCollection 2024.

Abstract

One countermeasure against the increasing prevalence of multimorbidity is the need to provide clinical education and training that considers the characteristics of physicians. We conducted a questionnaire survey to determine the relationship between physicians' characteristics and their approach to treating older patients with multimorbidity. A total of 3300 geriatric specialists and primary care specialists in Japan were enrolled. A 4-point Likert scale was used to score the following items: difficult diseases (43 items), difficult patient backgrounds (14 items), important clinical factors (32 items), and important clinical management (32 items). Exploratory factor analysis was performed to examine the constructs in each of the scales Diseases, Backgrounds, Clinical Factors, and Clinical Management, and group comparisons by physician characteristics were conducted. A total of 778 respondents were included in the analysis. Six factors for Diseases, two factors for Patient Background, four factors for Clinical Factors, and two factors for Clinical Management were explored as patterns. Group comparison between mean scores for each factor and the characteristics of responding physicians showed statistically significant differences in at least one factor for all patterns in terms of years of experience as a physician (26 years or less, 27 years or more), the clinical setting (providing or not providing home medical care), and sex (male or female). Our results suggest a need for clinical education and training that takes into account not only physicians' experience and clinical setting, but also their sex.

摘要

应对多病共存患病率不断上升的一种对策是,需要提供考虑到医生特点的临床教育和培训。我们进行了一项问卷调查,以确定医生的特征与其治疗多病共存的老年患者的方法之间的关系。在日本共招募了 3300 名老年病专家和初级保健专家。采用 4 点 Likert 量表对以下项目进行评分:疑难疾病(43 项)、疑难患者背景(14 项)、重要临床因素(32 项)和重要临床管理(32 项)。进行了探索性因子分析,以检查每个疾病、背景、临床因素和临床管理量表中的结构,并按医生特征进行了组间比较。共纳入 778 名应答者进行分析。探索出了疾病、背景、临床因素和临床管理的 6 个因素、2 个患者背景因素、4 个临床因素和 2 个临床管理因素。对每个因素的平均得分与应答医生的特征进行组间比较,结果表明,在所有模式中,医生的从业年限(26 年或以下,27 年或以上)、临床环境(是否提供家庭医疗保健)和性别(男性或女性)至少在一个因素上存在统计学差异。我们的结果表明,需要进行临床教育和培训,不仅要考虑医生的经验和临床环境,还要考虑他们的性别。

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