Loayssa Lara J R, García García M, Gaminde Inda I, Vilches Plaza C
Unidad de Docencia, Formación Continuada e Investigación, Dirección de Atención Primaria, Navarra.
Aten Primaria. 1995 Apr 15;15(6):390-2.
To identify family doctors' (FD) perceptions of the doctor-patient relationship and the factors conditioning those perceptions.
A descriptive crossover study. Using the technique of the discussion group, the contributions of FD from both the rural and urban areas were collected. The discussion was taped, transcribed (language and paralanguage) and analysed inductively.
Health centres in Navarra.
12 urban and 8 rural FD were chosen in order to include those variables (sensitivity to the question, professional field, age, years of experience and gender) which would lead to both a wide-ranging discussion and joint work.
The FD felt they were little valued and had lost responsibilities. Patients were perceived negatively on the whole and doctors' relationship with them was lived as something unsatisfactory and full of obstacles. "Difficult" patients, along with the possibility of committing technical errors, were clearly matters of concern. Although the responsibility of external factors was emphasised, the need to reconsider their own behaviour was recognised, as was the need for special training to improve their relationships with patients.
The attitudes of FD do not make the construction of positive relationships with patients easy and can lead into a process of serious professional and personal frustration. Neutralising this process, through a series of measures not restricted to training, is a priority in primary care development.
确定家庭医生对医患关系的看法以及影响这些看法的因素。
一项描述性交叉研究。采用讨论小组技术,收集了城乡家庭医生的意见。讨论过程进行了录音、转录(语言和副语言)并进行归纳分析。
纳瓦拉的健康中心。
选择了12名城市家庭医生和8名农村家庭医生,以便纳入那些能够引发广泛讨论和合作的变量(对问题的敏感度、专业领域、年龄、工作经验和性别)。
家庭医生觉得自己不受重视且失去了职责。总体而言,患者被负面看待,医生与他们的关系被认为不尽人意且充满障碍。“难缠”的患者以及出现技术失误的可能性显然令人担忧。虽然强调了外部因素的责任,但也认识到需要重新审视自身行为,以及需要接受特殊培训以改善与患者的关系。
家庭医生的态度不利于与患者建立积极的关系,可能导致严重的职业和个人挫折感。通过一系列不限于培训的措施来消除这一过程,是初级保健发展的当务之急。