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虚拟医疗整合:平衡医生的身心健康

Virtual Care Integration: Balancing Physician Well-Being.

作者信息

LaPlante Gabriel, Babenko Oksana, Neufeld Adam

机构信息

Department of Family Medicine, University of Alberta, Canada.

Department of Family Medicine, University of Calgary, Canada.

出版信息

PRiMER. 2024 Jun 11;8:32. doi: 10.22454/PRiMER.2024.690812. eCollection 2024.

DOI:10.22454/PRiMER.2024.690812
PMID:38946752
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11212693/
Abstract

BACKGROUND AND OBJECTIVES

According to self-determination theory (SDT), fulfillment of three basic psychological needs-autonomy, competence, and relatedness-positively impacts people's health and well-being. Amid the COVID-19 pandemic, an accelerated adoption of virtual care practices coincided with a decline in the well-being of physicians. Taking into account the frequency of virtual care use, we examined the relationship between workplace need fulfillment and physician well-being.

METHODS

Using online survey methodology, in March through June 2022, we collected data from 156 family physicians (FPs) in Alberta, Canada. The survey contained scales that measured workplace need satisfaction and frustration, subjective well-being (physical, psychological, and relational), and frequency of virtual care use. We performed correlational and regression analyses of the data.

RESULTS

More frequent use of virtual care was associated with lower relatedness satisfaction among FPs. Controlling for the frequency of virtual care use, frustration of autonomy and competence needs negatively related to FPs' physical well-being; frustration of competence and relatedness needs negatively related to their psychological and relational well-being.

CONCLUSIONS

Findings from this study align with SDT and underscore the importance of supporting FPs' basic psychological needs, while we work to integrate virtual care into clinical practice. In their day-to-day work, we encourage physicians to reflect on their own sense of autonomy, competence, and relatedness, and consider how using virtual care aligns with these basic needs.

摘要

背景与目的

根据自我决定理论(SDT),满足自主性、能力和关联性这三种基本心理需求对人们的健康和幸福有积极影响。在新冠疫情期间,虚拟医疗实践的加速采用与医生幸福感的下降同时出现。考虑到虚拟医疗的使用频率,我们研究了工作场所需求满足与医生幸福感之间的关系。

方法

采用在线调查方法,于2022年3月至6月从加拿大艾伯塔省的156名家庭医生(FPs)收集数据。该调查包含测量工作场所需求满意度和挫折感、主观幸福感(身体、心理和人际关系方面)以及虚拟医疗使用频率的量表。我们对数据进行了相关性和回归分析。

结果

虚拟医疗使用频率越高,家庭医生的关联性满意度越低。在控制虚拟医疗使用频率的情况下,自主性和能力需求的挫折感与家庭医生的身体健康呈负相关;能力和关联性需求的挫折感与他们的心理和人际关系幸福感呈负相关。

结论

本研究结果与自我决定理论一致,强调了在努力将虚拟医疗整合到临床实践中时,支持家庭医生基本心理需求的重要性。在日常工作中,我们鼓励医生反思自己的自主性、能力和关联性意识,并考虑使用虚拟医疗如何与这些基本需求相契合。

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本文引用的文献

1
Family Physician Motivation and Well-Being in the Digital Era.家庭医生在数字时代的动机与幸福感。
Ann Fam Med. 2023 Nov-Dec;21(6):496-501. doi: 10.1370/afm.3031.
2
Assessing a Structured Mental Fitness Program for Academic Acute Care Surgeons: A Pilot Study.评估学术急救外科医生结构化心理适应能力计划:一项试点研究。
J Surg Res. 2024 Mar;295:9-18. doi: 10.1016/j.jss.2023.09.052. Epub 2023 Nov 11.
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Physicians' mental health and coping during the COVID-19 pandemic: One year exploration.新冠疫情期间医生的心理健康与应对:一年探索
Heliyon. 2023 May;9(5):e15762. doi: 10.1016/j.heliyon.2023.e15762. Epub 2023 May 4.
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Mental health and addiction health service use by physicians compared to non-physicians before and during the COVID-19 pandemic: A population-based cohort study in Ontario, Canada.在 COVID-19 大流行之前和期间,与非医师相比,医师对精神健康和成瘾健康服务的使用:安大略省,加拿大的一项基于人群的队列研究。
PLoS Med. 2023 Apr 18;20(4):e1004187. doi: 10.1371/journal.pmed.1004187. eCollection 2023 Apr.
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Characterizing the use of virtual care in primary care settings during the COVID-19 pandemic: a retrospective cohort study.描述 COVID-19 大流行期间初级保健环境中虚拟护理的使用情况:一项回顾性队列研究。
BMC Prim Care. 2022 Dec 10;23(1):320. doi: 10.1186/s12875-022-01890-w.
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Pride and adversity among nurses and physicians during the pandemic in two US healthcare systems: a mixed methods analysis.美国两个医疗系统中疫情期间护士和医生的骄傲与困境:一项混合方法分析
BMC Nurs. 2022 Nov 9;21(1):304. doi: 10.1186/s12912-022-01075-x.
7
Association of Virtual Care Expansion With Environmental Sustainability and Reduced Patient Costs During the COVID-19 Pandemic in Ontario, Canada.加拿大安大略省在 COVID-19 大流行期间,虚拟护理的扩张与环境可持续性和降低患者成本之间的关联。
JAMA Netw Open. 2022 Oct 3;5(10):e2237545. doi: 10.1001/jamanetworkopen.2022.37545.
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The Wicked Problem of Physician Well-Being.医生福祉的棘手问题。
Anesthesiol Clin. 2022 Jun;40(2):213-223. doi: 10.1016/j.anclin.2022.01.001. Epub 2022 May 4.
9
Telehealth, Social Media, Patient Empowerment, and Physician Burnout: Seeking Middle Ground.远程医疗、社交媒体、患者赋权和医生倦怠:寻求中间立场。
Am Soc Clin Oncol Educ Book. 2022 Apr;42:1-10. doi: 10.1200/EDBK_100030.
10
Associations of Telehealth Care Delivery with Pediatric Health Care Provider Well-Being.远程医疗服务与儿科医护人员健康状况的关联。
Appl Clin Inform. 2022 Jan;13(1):230-241. doi: 10.1055/s-0042-1742627. Epub 2022 Feb 16.