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“医生,你还好吗?” 一项扩展健康信念模型,探索医生值班时健康行为的经历和观点。

"Are you OK doctor?" An expanded health belief model exploration of doctors' experiences and perspectives of on-shift health behaviour.

机构信息

School of Psychology & Clinical Language Sciences, The University of Reading, Reading, UK.

出版信息

Int J Qual Stud Health Well-being. 2024 Dec;19(1):2388795. doi: 10.1080/17482631.2024.2388795. Epub 2024 Aug 5.

Abstract

PURPOSE

Understanding doctors' health beliefs is essential for developing effective and competent healthcare practices that benefit doctors and their patients. This study aimed to qualitatively explore doctors' perceptions of on-shift health-protective behaviours and their perceived effects on competence.

METHODS

The research applied theoretically driven Expanded Health Belief Model (EHBM) enquiry methods to explore beliefs and experiences through an occupational context survey, 14 individual depth interviews, and two focus groups. Semantic and deductive themes associated with EHBM domains were examined, and an inductive thematic analysis of the interviews was conducted.

RESULTS

Doctors' beliefs were strongly imbued by their perceived identity within the systemic context; they expressed impaired self-efficacy in reacting to their health needs on shift, and several disclosed harm to themselves and patients. Dominant themes included the psychosocial effects of the systemic culture and the influence of the situational occupational context in impacting health-protective behavioural action. The context and implications of experiences during the COVID-19 pandemic are discussed.

CONCLUSIONS

This study presents key belief-oriented factors influencing doctors' health-protective behaviour at work and its implications for competent practice. Further doctor-led guidance on focus points for evidence-based theoretically driven health improvement solutions is provided regarding operational practice, formulating policies, developing interventions and further research.

摘要

目的

了解医生的健康信念对于制定有益于医生及其患者的有效且有能力的医疗保健实践至关重要。本研究旨在定性探讨医生对轮班时健康保护行为的看法及其对能力的感知效果。

方法

该研究应用理论驱动的扩展健康信念模型(EHBM)查询方法,通过职业背景调查、14 次个人深度访谈和 2 次焦点小组,探索信念和经验。检查了与 EHBM 领域相关的语义和演绎主题,并对访谈进行了归纳主题分析。

结果

医生的信念深受其在系统环境中的感知身份的影响;他们在轮班时对自己的健康需求反应的自我效能感受损,并且有几个人透露自己和患者受到了伤害。主要主题包括系统文化的心理社会影响以及情境职业环境对健康保护行为的影响。还讨论了 COVID-19 大流行期间的经验背景和影响。

结论

本研究提出了影响医生工作中健康保护行为的关键信念导向因素及其对胜任实践的影响。进一步为医生提供了关于以证据为基础的理论驱动的健康改善解决方案的重点的指导,涉及运营实践、制定政策、制定干预措施和进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/700b/11305022/4d1cfc8db36b/ZQHW_A_2388795_F0001_OC.jpg

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